Physical activity, sedentary behaviors, physical fitness, and their relation to health outcomes in youth with type 1 and type 2 diabetes: A review of the epidemiologic literature

The aim of this study was to evaluate the effects of flash glucose monitoring on dietary variety, physical activity, and self-care behavior in patients with diabetes. This study included outpatients with diabetes using insulin who presented at the Department of Diabetes and Metabolism of the Ise Red Cross Hospital. Before initiating flash glucose monitoring and 12 weeks after its initiation, blood glucose-related parameters were assessed and self-administered questionnaires were completed (Dietary Variety Score (DVS), the International Physical Activity Questionnaire (IPAQ), the Summary of Diabetes Self-Care Activities Measure (SDSCA), and the Diabetes Treatment Satisfaction Questionnaire (DTSQ)) and compared between the two time points. We analyzed 42 patients with type 1 diabetes mellitus and 48 patients with type 2 diabetes mellitus. In patients with type 2 diabetes mellitus, but not type 1 diabetes mellitus, there was an increase in moderate/high category scores for IPAQ (P<0.001) and for treatment satisfaction reported via DTSQ. Furthermore, in patients with type 2 diabetes mellitus, the glycemic excursion index improved significantly and HbA1c decreased significantly (from 7.7 (1.2) to 7.4 (0.8), P=0.025). Results showed that standard deviation and mean amplitude of glycemic excursions significantly decreased in patients with type 1 diabetes mellitus (from 71.2 (20.4) to 66.2 (17.5), P=0.033 and from 124.6 (31.9) to 108.1 (28.4), P<0.001, respectively). Flash glucose monitoring is a useful tool to improve physical activity in patients with type 2 diabetes.

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Physical behaviors and chronotype in people with type 2 diabetes

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2020-001375 ◽

2020 ◽

Vol 8 (1) ◽

pp. e001375

Author(s):

Joseph Henson ◽

Alex V Rowlands ◽

Emma Baldry ◽

Emer M Brady ◽

Melanie J Davies ◽

...

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

Reference Group ◽

Vigorous Physical Activity ◽

Sleep Onset ◽

Sedentary Behaviors ◽

Intensity Gradient ◽

Average Acceleration ◽

Design And Methods

IntroductionPrevious investigations have suggested that evening chronotypes may be more susceptible to obesity-related metabolic alterations. However, whether device-measured physical behaviors differ by chronotype in those with type 2 diabetes (T2DM) remains unknown.Research design and methodsThis analysis reports data from the ongoing Chronotype of Patients with Type 2 Diabetes and Effect on Glycaemic Control (CODEC) observational study. Eligible participants were recruited from both primary and secondary care settings in the Midlands area, UK. Participants were asked to wear an accelerometer (GENEActiv, ActivInsights, Kimbolton, UK) on their non-dominant wrist for 7 days to quantify different physical behaviors (sleep, sedentary, light, moderate-to-vigorous physical activity (MVPA), intensity gradient, average acceleration and the acceleration above which the most active continuous 2, 10, 30 and 60 min are accumulated). Chronotype preference (morning, intermediate or evening) was assessed using the Morningness-Eveningness Questionnaire. Multiple linear regression analyses assessed whether chronotype preference was associated with physical behaviors and their timing. Evening chronotypes were considered as the reference group.Results635 participants were included (age=63.8±8.4 years, 34.6% female, body mass index=30.9±5.1 kg/m2). 25% (n=159) of the cohort were morning chronotypes, 52% (n=330) intermediate and 23% (n=146) evening chronotypes. Evening chronotypes had higher sedentary time (28.7 min/day, 95% CI 8.6 to 48.3) and lower MVPA levels (–9.7 min/day, –14.9 to –4.6) compared to morning chronotypes. The intensity of the most active continuous 2-60 min of the day, average acceleration and intensity gradient were lower in evening chronotypes. The timing of physical behaviors also differed across chronotypes, with evening chronotypes displaying a later sleep onset and consistently later physical activity time.ConclusionsPeople with T2DM lead a lifestyle characterized by sedentary behaviors and insufficient MVPA. This may be exacerbated in those with a preference for ‘eveningness’ (ie, go to bed late and get up late).

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A randomized trial investigating the 12-month changes in physical activity and health outcomes following a physical activity consultation delivered by a person or in written form in Type 2 diabetes: Time2Act

Diabetic Medicine ◽

10.1111/j.1464-5491.2009.02675.x ◽

2009 ◽

Vol 26 (3) ◽

pp. 293-301 ◽

Cited By ~ 33

Author(s):

A. Kirk ◽

J. Barnett ◽

G. Leese ◽

N. Mutrie

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

Health Outcomes ◽

Randomized Trial ◽

Written Form

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Clinical Measures of Physical Fitness Predict Insulin Resistance in People at Risk for Diabetes

Physical Therapy ◽

10.2522/ptj.20080064 ◽

2008 ◽

Vol 88 (11) ◽

pp. 1355-1364 ◽

Cited By ~ 31

Author(s):

Chiao-Nan Chen ◽

Lee-Ming Chuang ◽

Ying-Tai Wu

Keyword(s):

Physical Activity ◽

Insulin Resistance ◽

Type 2 Diabetes ◽

Body Mass Index ◽

At Risk ◽

Risk Factor ◽

Waist Circumference ◽

Physical Fitness ◽

Clinical Measures

Background and Purpose Physical inactivity has been well documented as a risk factor for type 2 diabetes. Previous studies measured the level of physical activity either with questionnaires or with direct measurements of maximum oxygen uptake. However, questionnaires are patient-report measures, and methods for obtaining direct maximum oxygen uptake measurements often are not available clinically. The purpose of this study was to investigate whether clinical measurement of health-related physical fitness with a simple test battery can predict insulin resistance, a precursor of type 2 diabetes, in people at risk for diabetes. Subjects and Methods A total of 151 volunteers with at least one diabetes risk factor (overweight, hypertension, dyslipidemia, family history, impaired glucose tolerance, gestational diabetes, or delivering a baby weighing more than 4.0 kg) were recruited. Insulin resistance (as determined with the homeostasis model assessment of insulin resistance [HOMA-IR]), physical fitness (including body composition, as determined with the body mass index and waist circumference), muscle strength (handgrip strength [force-generating capacity]), muscle endurance (sit-up test), flexibility (sit-and-reach test), and cardiorespiratory endurance (step test) were measured, and a physical activity questionnaire was administered. Backward regression analysis was used to build the prediction models for insulin resistance from components of physical fitness and physical activity. Results Body mass index, muscle strength, and cardiorespiratory fitness predicted HOMA-IR in men (adjusted R2=.264). In women, age, waist circumference, and cardiorespiratory fitness were the predictors of HOMA-IR (adjusted R2=.438). Discussion and Conclusion Clinical measures of physical fitness can predict insulin resistance in people at risk for diabetes. The findings support the validity of clinical measures of physical fitness for predicting insulin resistance in people at risk for diabetes.

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The association between physical activity, physical fitness, and type 2 diabetes mellitus

Comprehensive Therapy ◽

10.1007/s12019-000-0006-9 ◽

2000 ◽

Vol 26 (3) ◽

pp. 176-182 ◽

Cited By ~ 24

Author(s):

Ming Wei ◽

Harvey A. Schwertner ◽

Steven N. Blair

Keyword(s):

Physical Activity ◽

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Physical Fitness

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Walking: a matter of quantity and quality physical activity for type 2 diabetes management

Applied Physiology Nutrition and Metabolism ◽

10.1139/h08-055 ◽

2008 ◽

Vol 33 (4) ◽

pp. 797-801 ◽

Cited By ~ 11

Author(s):

Steven T. Johnson ◽

Normand G. Boulé ◽

Gordon J. Bell ◽

Rhonda C. Bell

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

Clinical Practice ◽

Health Outcomes ◽

Walking Speed ◽

Diabetes Management ◽

Health Benefit ◽

Current Clinical Practice ◽

Steps Per Day

Walking is often prescribed as a mode of physical activity for people with type 2 diabetes (T2D). We and others have found that although people with T2D may increase the amount that they walk (e.g., more steps per day), improvements in key health outcomes are rarely achieved. We agree that walking is an acceptable approach for people with T2D to meet current clinical practice guidelines, but consideration of both the total number of daily steps and the walking speed of a portion of those total daily steps are necessary to gain health benefit.

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Co-morbidity, functionality and time since diagnosis as predictors of physical activity in individuals with type 1 or type 2 diabetes

Diabetes Research and Clinical Practice ◽

10.1016/j.diabres.2007.02.016 ◽

2007 ◽

Vol 78 (1) ◽

pp. 115-122 ◽

Cited By ~ 17

Author(s):

Ronald C. Plotnikoff ◽

Sonia Lippke ◽

Nandini Karunamuni ◽

Neil Eves ◽

Kerry S. Courneya ◽

...

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

Co Morbidity ◽

Time Since Diagnosis

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Relationships of Changes in Physical Activity and Sedentary Behavior With Changes in Physical Fitness and Cardiometabolic Risk Profile in Individuals With Type 2 Diabetes: The Italian Diabetes and Exercise Study 2 (IDES_2)

10.2337/figshare.16746262.v2 ◽

2021 ◽

Author(s):

Stefano Balducci ◽

Jonida Haxhi ◽

Massimo Sacchetti ◽

Giorgio Orlando ◽

Patrizia Cardelli ◽

...

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Type 2 Diabetes ◽

Cardiovascular Risk ◽

Physical Fitness ◽

Cardiovascular Risk Factors ◽

Risk Profile ◽

Risk Scores ◽

Metabolic Equivalents

<a>Objective.</a> In the Italian Diabetes and Exercise Study_2, a behavioral counseling <a>promoted</a> a sustained increase in physical activity (PA) volume (+3.3 metabolic equivalents-hour·week-1), moderate-to-vigorous-intensity PA (MVPA, +6.4 min·day-1), and light-intensity PA (LPA, +0.8 hours·day-1) and decrease in sedentary time (SED-time, -0.8 hours·day-1). Here, we investigated <a>the relationships of changes in PA/SED-time with changes in physical fitness and cardio-metabolic risk profile in individuals with type 2 diabetes</a>. Research Design and Methods. <a>In this 3-year randomized clinical trial, 300 physically inactive and sedentary patients were randomized 1:1 to receive one-month theoretical and practical counseling once-a-year or standard care. </a>Changes in physical fitness and cardiovascular risk factors/scores according to quartiles of accelerometer-measured changes in PA/SED-time were assessed, together with univariate and multivariable associations between these parameters<a>, in the whole cohort and by study arm</a>. Results. Physical fitness increased and HbA1c and coronary heart disease 10-year risk scores decreased with quartiles of MVPA and SED-time change. In quartile IV of MVPA increase and SED-time decrease, cardiorespiratory fitness increased by 5.23 and 4.49 ml·min-1·kg-1 and HbA1c decreased by 0.73 and 0.85%, respectively. Univariate correlations confirmed these relationships and mean changes in both MPVA and SED-time predicted changes in physical fitness and cardiovascular risk factors/scores independently of one another and of other confounders. Similar findings were observed with LPA and PA volume and in each group separately. Conclusions. Even modest increments in MVPA may have a clinically meaningful impact and reallocating SED-time to LPA may also contribute to improve outcomes, possibly by increasing total energy expenditure.

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