DIAGNOSIS WITH TYPE 2 DIABETES AND CHANGES IN PHYSICAL ACTIVITY AMONG MIDDLE-AGED AND OLDER ADULTS IN THE U.S.

BACKGROUND Incorporating physical activity in lifestyle routines is recommended for individuals living with type 2 diabetes. Accelerometer devices offer a promising alternative to self-report methods for measuring physical activity performance. However, the extant literature for accelerometer-measured physical activity among middle-aged/older adults with chronic conditions is lacking. OBJECTIVE We conducted a comprehensive scoping review of the literature to capture accelerometry methodologies in older adults with type 2 diabetes, specifically in relation to cutpoints that classify physical activity into intensity categories (sedentary, light, moderate, vigorous, very vigorous). METHODS Applying the Joanna Briggs Institute’s methodology, we searched PubMed, Web of Science, EMBASE, and Engineering Village to identify studies that used research-grade accelerometers to objectively measure physical activity intensity levels of adults with type 2 diabetes using cutpoints in participant samples of mean age 50 years and older. RESULTS We identified 46 studies that met our inclusion criteria. The ActiGraph was the most popular accelerometer among researchers, and the Freedson (1998) and Troiano (2008) cutpoints were favored the most. The Lopes (2009) cutpoints were developed by calibrating the ActiGraph accelerometer in middle-aged and older adults with overweight/ obesity and type 2 diabetes. Several studies noted limitations of accelerometry use that could lead to an underestimation or inaccurate representation of physical activity for our population of interest. Limitations included decreased accuracy due to variation in device placement and underestimation of activity intensity attributed to using cutpoints in older adults with lower fitness levels that were originally validated with younger adults. CONCLUSIONS Considering the high variability among accelerometry methodologies, more work needs to be done to understand activity intensity cut-offs for populations with a high burden of chronic disease, older age, and suboptimal physical functioning.

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Sex-specific association of BMI change with stroke in middle-aged and older adults with type 2 diabetes

Nutrition Metabolism and Cardiovascular Diseases ◽

10.1016/j.numecd.2021.07.007 ◽

2021 ◽

Author(s):

Cancan Cui ◽

Zhiyuan Wu ◽

Yunke Shi ◽

Zhonghang Xu ◽

Bing Zhao ◽

...

Keyword(s):

Type 2 Diabetes ◽

Older Adults ◽

Middle Aged ◽

Specific Association

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Low-intensity physical activity is associated with reduced risk of incident type 2 diabetes in older adults: evidence from the English Longitudinal Study of Ageing

Diabetologia ◽

10.1007/s00125-010-1785-x ◽

2010 ◽

Vol 53 (9) ◽

pp. 1877-1885 ◽

Cited By ~ 85

Author(s):

P. Demakakos ◽

M. Hamer ◽

E. Stamatakis ◽

A. Steptoe

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

Older Adults ◽

Incident Type ◽

Low Intensity ◽

Incident Type 2 Diabetes ◽

Intensity Physical Activity ◽

English Longitudinal Study ◽

Reduced Risk

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Does Interrupting Prolonged Sitting With 10- or 20-Min Standing Attenuate Postprandial Glycemia and Blood Pressure in Middle-Aged and Older Adults With Type 2 Diabetes?

Journal of Aging and Physical Activity ◽

10.1123/japa.2020-0418 ◽

2020 ◽

pp. 1-8

Author(s):

Yuri A. Freire ◽

Carlos A. Silva ◽

Geovani A. D. Macêdo ◽

Rodrigo A. V. Browne ◽

Bruno M. de Oliveira ◽

...

Keyword(s):

Blood Pressure ◽

Type 2 Diabetes ◽

Older Adults ◽

Area Under The Curve ◽

Acute Effect ◽

Sitting Time ◽

Middle Aged ◽

Postprandial Glycemia ◽

Prolonged Sitting

We carried out three types of 2-hr experimental sessions with middle-aged and older adults with Type 2 diabetes in order to examine the acute effect of interrupting prolonged sitting with varying periods of standing on postprandial glycemia and blood pressure (BP): (a) prolonged sitting after breakfast; (b) standing for 10 min, 30 min after breakfast; and (c) standing for 20 min, 30 min after breakfast. Glucose and BP were assessed before and after breakfast. A generalized linear model revealed no significant differences for the incremental area under the curve of glucose between standing for 10 min, 30 min after breakfast, versus prolonged sitting after breakfast (β = –4.5 mg/dl/2 hr, 95% CI [–17.3, 8.4]) and standing for 20 min, 30 min after breakfast, versus prolonged sitting after breakfast (β = 0.9 mg/dl/2 hr, 95% CI [–11.9, 13.7]). There was no difference in area under the curve of systolic and diastolic BP among the sessions. Interrupting prolonged sitting time with 10 or 20 min of standing 30 min after breakfast does not attenuate postprandial glycemia or BP in middle-aged and older adults with Type 2 diabetes.

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Abstract 16: Economic Cost of Type 2 Diabetes Attributable to Physical Inactivity in the United States in 2012

Circulation ◽

10.1161/circ.133.suppl_1.16 ◽

2016 ◽

Vol 133 (suppl_1) ◽

Author(s):

Priyank P Shah ◽

Fayez Shamoon ◽

Mahesh Bikkina ◽

Harold Kohl

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

Physical Inactivity ◽

Leisure Time ◽

Sensitivity Analyses ◽

Physical Activity Guidelines ◽

Average Annual Cost ◽

The Cost ◽

The U.S

Objective: Type 2 diabetes has grown to epidemic proportions in the U.S. and physical activity levels in the population continues to remain low, although it is a major primary preventive strategy for diabetes. The objectives of this study were to estimate the direct medical costs of type 2 diabetes attributable to not meeting physical activity Guidelines and to physical inactivity in the U.S. in 2012. Methods: This was a cross sectional study that used physical activity prevalence data from the 2012 Behavioral Risk Factor Surveillance System (BRFSS). Estimates of relative risk of type 2 diabetes for subjects not engaging in any leisure time physical activity and those not meeting physical activity guidelines were obtained for multiple studies published in the literature. Using the prevalence of not meeting physical activity guidelines, physical inactivity and the respective relative risks, the population attributable risk percentage (PAR%) for type 2 diabetes was estimated by Levin’s formula. These data were combined with the prevalence and cost data of type 2 diabetes (in 2012) to estimate the cost of type 2 diabetes attributable to not meeting physical activity Guidelines, and to physical inactivity in 2012. Sensitivity analyses were done for i) varying the prevalence of not meeting physical activity guidelines from 30-70%, and ii) varying the average annual cost of type 2 diabetes from $4394 (for person less than 45 years of age) to $11825 (for person greater than 65 years of age). Results: The prevalence of U.S. population meeting physical activity guidelines and engaging in no leisure time activity was 50% and 30% respectively in 2012. The average annual cost attributable to type 2 diabetes in the US, was $7888 per person. The cost of type 2 diabetes in the U.S. in 2012, attributable to not meeting physical activity guidelines was estimated to be $18.6 billion, and that attributable to physical inactivity was estimated to be $5.9 billion. Based on sensitivity analyses, these estimates ranged from $10.36 billion to $27.9 billion for not meeting physical activity guidelines and $3.3 billion to $8.87 billion for physical inactivity in the year 2012. Conclusions: This study shows that billions of dollars could be saved annually just in terms of type 2 diabetes cost in the U.S., if the entire adult population was active enough to meet physical activity guidelines. Physical activity promotion, particularly at the environmental and policy level should be a priority in the population.

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