Objective measurements of activity patterns in people with newly diagnosed Type 2 diabetes demonstrate a sedentary lifestyle

Cichosz, Simon Lebech; Fleischer, Jesper; Hoeyem, Pernille; Laugesen, Esben; Poulsen, Per Løgstrup; Js, Christiansen; Ejskjær, Niels; Hansen, Troels Krarup

doi:10.1111/dme.12199

Cited by 47 publications

(38 citation statements)

References 18 publications

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“…Concerning physical activity, we found increased self-reported levels among Type 2 DM patients, which is against the study by Cichosz et al . who reported less time spent on moderate to vigorous physical activity among Type 2 DM patients compared with controls without diabetes (34 minutes vs. 62 minutes) [21]. The discrepancies may be related to selection of hospital-based patients with relatively severe Type 2 DM, and/or recruitment of relatively healthy controls, in previous studies as compared with our population-based survey.…”

Section: Discussionmentioning

confidence: 55%

“…Concerning obesity, Cichosz et al . reported higher BMI in 100 newly diagnosed Danish Type 2 DM patients compared to 100 age- and gender-matched population controls (30 kg/m 2 vs. 26 kg/m 2 ) [21]. Recently, 87% of newly diagnosed Danish Type 2 DM patients (median age at diagnosis: 59 years) were found to be either overweight or obese in the prospective DD2 study during 2010–2011, and 65% were obese [22].…”

Section: Discussionmentioning

confidence: 99%

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Lifestyle Factors Associated with Type 2 Diabetes and Use of Different Glucose-Lowering Drugs: Cross-Sectional Study

et al. 2014

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AimsTo examine the lifestyle profile among persons with and without Type 2 diabetes mellitus (DM) and among users of different glucose-lowering drugs.MethodsWe used questionnaire data from a Danish health survey and identified presence of Type 2 DM and use of medications through medical databases. We calculated age- and gender-standardized prevalence ratios (PRs) of lifestyle factors according to Type 2 DM and different glucose-lowering drugs.ResultsOf 21,637 survey participants aged 25–79 years, 680 (3%) had Type 2 DM (median age 63 years) with a median diabetes duration of 5 years. Participants with Type 2 DM had a substantially higher prevalence of obesity (36% vs. 13%, PR: 3.1, 95% confidence interval (CI): 2.8–3.6), yet more reported to eat a very healthy diet (25% vs. 21%, PR: 1.2, 95% CI: 1.0–1.4) and to exercise regularly (67% vs. 53%, PR: 1.3, 95% CI: 1.2–1.4). Also, fewer were current smokers or had high alcohol intake. When compared with metformin users, obesity was substantially less prevalent in users of sulfonylurea (PR: 0.5, 95% CI: 0.4–0-8), and insulin and analogues (PR: 0.4, 95% CI: 0.3–0.7). Tobacco smoking was more prevalent in sulfonylurea users (PR: 1.4, 95% CI: 0.9–2.1) compared with metformin users. We found no material differences in physical exercise, diet or alcohol intake according to type of glucose-lowering drug.ConclusionsType 2 DM patients are substantially more obese than other individuals, but otherwise report to have a healthier lifestyle. Metformin use is strongly associated with obesity, whereas sulfonylurea use tends to be associated with tobacco smoking.

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Section: Discussionmentioning

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Lifestyle Factors Associated with Type 2 Diabetes and Use of Different Glucose-Lowering Drugs: Cross-Sectional Study

et al. 2014

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“…The cohort is part of an ongoing study of type 2 diabetes complications (19)(20)(21). In brief, inclusion criteria were age .18 years, diagnosis of type 2 diabetes according to World Health Organization criteria, known duration of diabetes ,5 years, no insulin treatment, and no cardiac autonomic neuropathy diagnosis.…”

Section: Methodsmentioning

confidence: 99%

Glycemic Variability Is Associated With Reduced Cardiac Autonomic Modulation in Women With Type 2 Diabetes

et al. 2015

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OBJECTIVETo investigate the sex differences in cardiac autonomic modulation in patients with newly diagnosed type 2 diabetes and to determine whether cardiac autonomic modulation is associated with glycemic variability. RESEARCH DESIGN AND METHODSWe investigated a cohort consisting of 48 men and 39 women with non-insulin-treated type 2 diabetes and a known duration of diabetes <5 years. All patients were equipped with a continuous glucose monitoring sensor for 3 days, and the mean amplitude of glycemic excursions (MAGE) was calculated to obtain individual glycemic variability. Cardiac autonomic modulation was quantified by analysis of heart rate variability (HRV) in time and frequency domains and during cardiovascular reflex tests (response to standing [RS], deep breathing [expiration-inspiration], and Valsalva maneuver). RESULTSSex differences in age-and heart rate-adjusted HRV measures were observed in both active and passive tests. Low frequency (LF; P = 0.036), LF/high frequency (HF; P < 0.001), and RS (P = 0.006) were higher in men, whereas expiration-inspiration (P < 0.001), but not HF, was higher in women. In women, reduced cardiac autonomic modulation as assessed by the standard deviation of normal-to-normal intervals (P = 0.001), the root mean square of successive differences (P = 0.018), LF (P < 0.001), HF (P = 0.005), total power (P = 0.008), RS ratio (P = 0.027), and expiration-to-inspiration ratio (P = 0.006) was significantly associated with increased glycemic variability as assessed by MAGE. This was not the case in men. The association in women persisted in a multivariate regression analysis controlling for weight, mean heart rate, blood pressure (systolic), and triglycerides. CONCLUSIONSIn patients with newly diagnosed and well-controlled type 2 diabetes, increased glycemic variability was associated with reduced cardiac autonomic modulation in women but not in men.Evidence points toward a cardioprotective effect of sex hormones (estrogen and progesterone) in premenopausal women, one possibly mediated through improved cardiac autonomic balance both centrally and peripherally by suppression of sympathetic tone and elevation of parasympathetic tone (1,2). The presence of diabetes has been shown to reduce the sex difference and minimize cardioprotection in

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“…However, despite its known benefits, meeting prescribed exercise guidelines can be challenging and many with type 2 diabetes remain physically inactive [9][10][11]. Furthermore, sedentary behaviours increase the risk of type 2 diabetes and cardiovascular disease, even after controlling for leisure time spent in moderate-to-vigorous physical activity [2,6].…”

Section: Why Is This Study Of Interest?mentioning

confidence: 99%

Adding exercise or subtracting sitting time for glycaemic control: where do we stand?

2016

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While regular structured exercise is a wellestablished (though arguably under-utilised) cornerstone in the prevention and management of type 2 diabetes, population adherence to recommended exercise guidelines remains stubbornly low. Indeed, most adults are exposed to environmental settings (at work, in automobile travel and in the domestic environment) that may not only limit their physical activity, but also promote sitting for prolonged periods of time. However, recent experimental evidence indicates that reducing and breaking up sitting time may also be a useful strategy to improve glycaemic control. In this issue of Diabetologia, Duvivier and colleagues report findings which suggest that reducing sitting time with standing and light-intensity activity could be a potential alternative to structured exercise for improving glycaemic control in type 2 diabetes patients. We review and discuss the findings of this study, its potential clinical implications, and a number of knowledge gaps and opportunities that could be considered in the interest of future research. The findings from Duvivier and colleagues should encourage healthcare practitioners, researchers and type 2 diabetes patients to consider the whole spectrum of physical activity, from sedentary behaviour through to structured exercise.

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Objective measurements of activity patterns in people with newly diagnosed Type 2 diabetes demonstrate a sedentary lifestyle

Abstract: Using objective measurements, our findings demonstrate that people with newly diagnosed Type 2 diabetes have a more sedentary lifestyle compared with well-matched controls.

Cited by 47 publications

References 18 publications

Lifestyle Factors Associated with Type 2 Diabetes and Use of Different Glucose-Lowering Drugs: Cross-Sectional Study

Lifestyle Factors Associated with Type 2 Diabetes and Use of Different Glucose-Lowering Drugs: Cross-Sectional Study

Glycemic Variability Is Associated With Reduced Cardiac Autonomic Modulation in Women With Type 2 Diabetes

Adding exercise or subtracting sitting time for glycaemic control: where do we stand?

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