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This randomized clinical trial assessed the relationship between an increase in physical activity and the cardiometabolic profile of patients with type 2 diabetes (T2D). As physical activity increased from baseline, there was a linear decrease in both HbA1c and coronary heart disease risk scores. Furthermore, light intensity physical activity, defined as 0.8 hours/day, was associated with a statistically significant improvement in cardiometabolic profile compared with the sedentary group.
There is a linear relationship between physical activity and improvement in cardiometabolic profile in patients with T2D.
In the Italian Diabetes and Exercise Study_2 (IDES_2), behavioral counseling promoted a sustained increase in physical activity (PA) volume (+3.3 MET h ⋅ week-1), moderate- to vigorous-intensity PA (MVPA) (+6.4 min ⋅ day-1), and light-intensity PA (LPA) (+0.8 h ⋅ day-1) and decrease in sedentary time (SED-time) (-0.8 h ⋅ day-1). Here, we investigated the relationships of changes in PA/SED-time with changes in physical fitness and cardiometabolic risk profile in individuals with type 2 diabetes.
RESEARCH DESIGN AND METHODS
In this 3-year randomized clinical trial, 300 physically inactive and sedentary patients were randomized 1:1 to receive 1-month theoretical and practical counseling once a year or standard care. 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, in the whole cohort and by study arm.
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.
Even modest increments in MVPA may have a clinically meaningful impact, and reallocating SED-time to LPA may also contribute to improved outcomes, possibly by increasing total energy expenditure.
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)
Diabetes Care 2021 Nov 02;[EPub Ahead of Print], S Balducci, J Haxhi, M Sacchetti, G Orlando, P Cardelli, M Vitale, L Mattia, C Iacobini, L Bollanti, F Conti, S Zanuso, A Nicolucci, G Pugliese