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Breaking sitting with light activities vs structured exercise: a randomised crossover study demonstrating benefits for glycaemic control and insulin sensitivity in type 2 diabetes

AIMS/HYPOTHESIS: We aimed to examine the effects of breaking sitting with standing and light-intensity walking vs an energy-matched bout of structured exercise on 24 h glucose levels and insulin resistance in patients with type 2 diabetes. METHODS: In a randomised crossover study, 19 patients with t... Full description

Journal Title: Diabetologia 2017, Vol.60 (3), p.490-498
Main Author: Duvivier, Bernard M F M
Other Authors: Schaper, Nicolaas C , Hesselink, Matthijs K C , van Kan, Linh , Stienen, Nathalie , Winkens, Bjorn , Koster, Annemarie , Savelberg, Hans H C M
Format: Electronic Article Electronic Article
Language: English
Subjects:
ing
Publisher: Berlin/Heidelberg: Springer Berlin Heidelberg
ID: ISSN: 0012-186X
Link: https://www.ncbi.nlm.nih.gov/pubmed/27904925
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title: Breaking sitting with light activities vs structured exercise: a randomised crossover study demonstrating benefits for glycaemic control and insulin sensitivity in type 2 diabetes
format: Article
creator:
  • Duvivier, Bernard M F M
  • Schaper, Nicolaas C
  • Hesselink, Matthijs K C
  • van Kan, Linh
  • Stienen, Nathalie
  • Winkens, Bjorn
  • Koster, Annemarie
  • Savelberg, Hans H C M
subjects:
  • ACTIVITY MONITOR
  • ADULTS
  • Aged
  • Blood Glucose
  • Blood Glucose - metabolism
  • Blood sugar monitoring
  • Cross
  • Cross-Over Studies
  • Dextrose
  • Diabetes
  • Diabetes Mellitus
  • Diabetes Mellitus, Type 2
  • Diabetes Mellitus, Type 2 - blood
  • Diabetes Mellitus, Type 2 - therapy
  • Diabetes therapy
  • Endocrinology
  • Exercise
  • Exercise - physiology
  • Female
  • GLUCOSE
  • Glycaemic control
  • Human Physiology
  • Humans
  • ing
  • Insulin
  • Insulin - metabolism
  • Insulin Resistance
  • Insulin Resistance - physiology
  • Insulin sensitivity
  • intensity physical activity
  • Internal Medicine
  • Light
  • Light-intensity physical activity
  • Lipid Metabolism
  • Lipid Metabolism - physiology
  • Male
  • Medicine
  • Medicine & Public Health
  • METAANALYSIS
  • Metabolic Diseases
  • Metabolism
  • Middle Aged
  • MUSCLE
  • OBESITY
  • omized Controlled Trial
  • Over Studies
  • PHYSICAL-ACTIVITY
  • Physiological aspects
  • Posture
  • Posture - physiology
  • Randomized Controlled Trial
  • Resveratrol
  • Sedentary Behavior
  • Sedentary behaviour
  • Sedentary breaks
  • Sedentary Lifestyle
  • SEDENTARY TIME
  • Standing
  • Type 2
  • Type 2 diabetes
  • VALIDITY
  • Walking
  • Walking - physiology
ispartof: Diabetologia, 2017, Vol.60 (3), p.490-498
description: AIMS/HYPOTHESIS: We aimed to examine the effects of breaking sitting with standing and light-intensity walking vs an energy-matched bout of structured exercise on 24 h glucose levels and insulin resistance in patients with type 2 diabetes. METHODS: In a randomised crossover study, 19 patients with type 2 diabetes (13 men/6 women, 63 ± 9 years old) who were not using insulin each followed three regimens under free-living conditions, each lasting 4 days: (1) Sitting: 4415 steps/day with 14 h sitting/day; (2) Exercise: 4823 steps/day with 1.1 h/day of sitting replaced by moderate- to vigorous-intensity cycling (at an intensity of 5.9 metabolic equivalents [METs]); and (3) Sit Less: 17,502 steps/day with 4.7 h/day of sitting replaced by standing and light-intensity walking (an additional 2.5 h and 2.2 h, respectively, compared with the hours spent doing these activities in the Sitting regimen). Blocked randomisation was performed using a block size of six regimen orders using sealed, non-translucent envelopes. Individuals who assessed the outcomes were blinded to group assignment. Meals were standardised during each intervention. Physical activity and glucose levels were assessed for 24 h/day by accelerometry (activPAL) and a glucose monitor (iPro2), respectively. The incremental AUC (iAUC) for 24 h glucose (primary outcome) and insulin resistance (HOMA2-IR) were assessed on days 4 and 5, respectively. RESULTS: The iAUC for 24 h glucose (mean ± SEM) was significantly lower during the Sit Less intervention than in Sitting (1263 ± 189 min × mmol/l vs 1974 ± 324 min × mmol/l; p = 0.002), and was similar between Sit Less and Exercise (Exercise: 1383 ± 194 min × mmol/l; p = 0.499). Exercise failed to improve HOMA2-IR compared with Sitting (2.06 ± 0.28 vs 2.16 ± 0.26; p = 0.177). In contrast, Sit Less (1.89 ± 0.26) significantly reduced HOMA2-IR compared with Exercise (p = 0.015) as well as Sitting (p = 0.001). CONCLUSIONS/INTERPRETATION: Breaking sitting with standing and light-intensity walking effectively improved 24 h glucose levels and improved insulin sensitivity in individuals with type 2 diabetes to a greater extent than structured exercise. Thus, our results suggest that breaking sitting with standing and light-intensity walking may be an alternative to structured exercise to promote glycaemic control in patients type 2 diabetes. TRIAL REGISTRATION: Clinicaltrials.gov NCT02371239 FUNDING: : The study was supported by a Kootstra grant from Maastricht Univers
language: eng
source:
identifier: ISSN: 0012-186X
fulltext: no_fulltext
issn:
  • 0012-186X
  • 1432-0428
url: Link


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titleBreaking sitting with light activities vs structured exercise: a randomised crossover study demonstrating benefits for glycaemic control and insulin sensitivity in type 2 diabetes
creatorDuvivier, Bernard M F M ; Schaper, Nicolaas C ; Hesselink, Matthijs K C ; van Kan, Linh ; Stienen, Nathalie ; Winkens, Bjorn ; Koster, Annemarie ; Savelberg, Hans H C M
creatorcontribDuvivier, Bernard M F M ; Schaper, Nicolaas C ; Hesselink, Matthijs K C ; van Kan, Linh ; Stienen, Nathalie ; Winkens, Bjorn ; Koster, Annemarie ; Savelberg, Hans H C M
descriptionAIMS/HYPOTHESIS: We aimed to examine the effects of breaking sitting with standing and light-intensity walking vs an energy-matched bout of structured exercise on 24 h glucose levels and insulin resistance in patients with type 2 diabetes. METHODS: In a randomised crossover study, 19 patients with type 2 diabetes (13 men/6 women, 63 ± 9 years old) who were not using insulin each followed three regimens under free-living conditions, each lasting 4 days: (1) Sitting: 4415 steps/day with 14 h sitting/day; (2) Exercise: 4823 steps/day with 1.1 h/day of sitting replaced by moderate- to vigorous-intensity cycling (at an intensity of 5.9 metabolic equivalents [METs]); and (3) Sit Less: 17,502 steps/day with 4.7 h/day of sitting replaced by standing and light-intensity walking (an additional 2.5 h and 2.2 h, respectively, compared with the hours spent doing these activities in the Sitting regimen). Blocked randomisation was performed using a block size of six regimen orders using sealed, non-translucent envelopes. Individuals who assessed the outcomes were blinded to group assignment. Meals were standardised during each intervention. Physical activity and glucose levels were assessed for 24 h/day by accelerometry (activPAL) and a glucose monitor (iPro2), respectively. The incremental AUC (iAUC) for 24 h glucose (primary outcome) and insulin resistance (HOMA2-IR) were assessed on days 4 and 5, respectively. RESULTS: The iAUC for 24 h glucose (mean ± SEM) was significantly lower during the Sit Less intervention than in Sitting (1263 ± 189 min × mmol/l vs 1974 ± 324 min × mmol/l; p = 0.002), and was similar between Sit Less and Exercise (Exercise: 1383 ± 194 min × mmol/l; p = 0.499). Exercise failed to improve HOMA2-IR compared with Sitting (2.06 ± 0.28 vs 2.16 ± 0.26; p = 0.177). In contrast, Sit Less (1.89 ± 0.26) significantly reduced HOMA2-IR compared with Exercise (p = 0.015) as well as Sitting (p = 0.001). CONCLUSIONS/INTERPRETATION: Breaking sitting with standing and light-intensity walking effectively improved 24 h glucose levels and improved insulin sensitivity in individuals with type 2 diabetes to a greater extent than structured exercise. Thus, our results suggest that breaking sitting with standing and light-intensity walking may be an alternative to structured exercise to promote glycaemic control in patients type 2 diabetes. TRIAL REGISTRATION: Clinicaltrials.gov NCT02371239 FUNDING: : The study was supported by a Kootstra grant from Maastricht University Medical Centre+, and the Dutch Heart Foundation. Financial support was also provided by Novo Nordisk BV, and Medtronic and Roche made the equipment available for continuous glucose monitoring.
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publisherBerlin/Heidelberg: Springer Berlin Heidelberg
subjectACTIVITY MONITOR ; ADULTS ; Aged ; Blood Glucose ; Blood Glucose - metabolism ; Blood sugar monitoring ; Cross ; Cross-Over Studies ; Dextrose ; Diabetes ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Diabetes Mellitus, Type 2 - blood ; Diabetes Mellitus, Type 2 - therapy ; Diabetes therapy ; Endocrinology ; Exercise ; Exercise - physiology ; Female ; GLUCOSE ; Glycaemic control ; Human Physiology ; Humans ; ing ; Insulin ; Insulin - metabolism ; Insulin Resistance ; Insulin Resistance - physiology ; Insulin sensitivity ; intensity physical activity ; Internal Medicine ; Light ; Light-intensity physical activity ; Lipid Metabolism ; Lipid Metabolism - physiology ; Male ; Medicine ; Medicine & Public Health ; METAANALYSIS ; Metabolic Diseases ; Metabolism ; Middle Aged ; MUSCLE ; OBESITY ; omized Controlled Trial ; Over Studies ; PHYSICAL-ACTIVITY ; Physiological aspects ; Posture ; Posture - physiology ; Randomized Controlled Trial ; Resveratrol ; Sedentary Behavior ; Sedentary behaviour ; Sedentary breaks ; Sedentary Lifestyle ; SEDENTARY TIME ; Standing ; Type 2 ; Type 2 diabetes ; VALIDITY ; Walking ; Walking - physiology
ispartofDiabetologia, 2017, Vol.60 (3), p.490-498
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1Schaper, Nicolaas C
2Hesselink, Matthijs K C
3van Kan, Linh
4Stienen, Nathalie
5Winkens, Bjorn
6Koster, Annemarie
7Savelberg, Hans H C M
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0Breaking sitting with light activities vs structured exercise: a randomised crossover study demonstrating benefits for glycaemic control and insulin sensitivity in type 2 diabetes
1Diabetologia
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0Diabetologia
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descriptionAIMS/HYPOTHESIS: We aimed to examine the effects of breaking sitting with standing and light-intensity walking vs an energy-matched bout of structured exercise on 24 h glucose levels and insulin resistance in patients with type 2 diabetes. METHODS: In a randomised crossover study, 19 patients with type 2 diabetes (13 men/6 women, 63 ± 9 years old) who were not using insulin each followed three regimens under free-living conditions, each lasting 4 days: (1) Sitting: 4415 steps/day with 14 h sitting/day; (2) Exercise: 4823 steps/day with 1.1 h/day of sitting replaced by moderate- to vigorous-intensity cycling (at an intensity of 5.9 metabolic equivalents [METs]); and (3) Sit Less: 17,502 steps/day with 4.7 h/day of sitting replaced by standing and light-intensity walking (an additional 2.5 h and 2.2 h, respectively, compared with the hours spent doing these activities in the Sitting regimen). Blocked randomisation was performed using a block size of six regimen orders using sealed, non-translucent envelopes. Individuals who assessed the outcomes were blinded to group assignment. Meals were standardised during each intervention. Physical activity and glucose levels were assessed for 24 h/day by accelerometry (activPAL) and a glucose monitor (iPro2), respectively. The incremental AUC (iAUC) for 24 h glucose (primary outcome) and insulin resistance (HOMA2-IR) were assessed on days 4 and 5, respectively. RESULTS: The iAUC for 24 h glucose (mean ± SEM) was significantly lower during the Sit Less intervention than in Sitting (1263 ± 189 min × mmol/l vs 1974 ± 324 min × mmol/l; p = 0.002), and was similar between Sit Less and Exercise (Exercise: 1383 ± 194 min × mmol/l; p = 0.499). Exercise failed to improve HOMA2-IR compared with Sitting (2.06 ± 0.28 vs 2.16 ± 0.26; p = 0.177). In contrast, Sit Less (1.89 ± 0.26) significantly reduced HOMA2-IR compared with Exercise (p = 0.015) as well as Sitting (p = 0.001). CONCLUSIONS/INTERPRETATION: Breaking sitting with standing and light-intensity walking effectively improved 24 h glucose levels and improved insulin sensitivity in individuals with type 2 diabetes to a greater extent than structured exercise. Thus, our results suggest that breaking sitting with standing and light-intensity walking may be an alternative to structured exercise to promote glycaemic control in patients type 2 diabetes. TRIAL REGISTRATION: Clinicaltrials.gov NCT02371239 FUNDING: : The study was supported by a Kootstra grant from Maastricht University Medical Centre+, and the Dutch Heart Foundation. Financial support was also provided by Novo Nordisk BV, and Medtronic and Roche made the equipment available for continuous glucose monitoring.
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0ACTIVITY MONITOR
1ADULTS
2Aged
3Blood Glucose
4Blood Glucose - metabolism
5Blood sugar monitoring
6Cross
7Cross-Over Studies
8Dextrose
9Diabetes
10Diabetes Mellitus
11Diabetes Mellitus, Type 2
12Diabetes Mellitus, Type 2 - blood
13Diabetes Mellitus, Type 2 - therapy
14Diabetes therapy
15Endocrinology
16Exercise
17Exercise - physiology
18Female
19GLUCOSE
20Glycaemic control
21Human Physiology
22Humans
23ing
24Insulin
25Insulin - metabolism
26Insulin Resistance
27Insulin Resistance - physiology
28Insulin sensitivity
29intensity physical activity
30Internal Medicine
31Light
32Light-intensity physical activity
33Lipid Metabolism
34Lipid Metabolism - physiology
35Male
36Medicine
37Medicine & Public Health
38METAANALYSIS
39Metabolic Diseases
40Metabolism
41Middle Aged
42MUSCLE
43OBESITY
44omized Controlled Trial
45Over Studies
46PHYSICAL-ACTIVITY
47Physiological aspects
48Posture
49Posture - physiology
50Randomized Controlled Trial
51Resveratrol
52Sedentary Behavior
53Sedentary behaviour
54Sedentary breaks
55Sedentary Lifestyle
56SEDENTARY TIME
57Standing
58Type 2
59Type 2 diabetes
60VALIDITY
61Walking
62Walking - physiology
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titleBreaking sitting with light activities vs structured exercise: a randomised crossover study demonstrating benefits for glycaemic control and insulin sensitivity in type 2 diabetes
authorDuvivier, Bernard M F M ; Schaper, Nicolaas C ; Hesselink, Matthijs K C ; van Kan, Linh ; Stienen, Nathalie ; Winkens, Bjorn ; Koster, Annemarie ; Savelberg, Hans H C M
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1ADULTS
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3Blood Glucose
4Blood Glucose - metabolism
5Blood sugar monitoring
6Cross
7Cross-Over Studies
8Dextrose
9Diabetes
10Diabetes Mellitus
11Diabetes Mellitus, Type 2
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13Diabetes Mellitus, Type 2 - therapy
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51Resveratrol
52Sedentary Behavior
53Sedentary behaviour
54Sedentary breaks
55Sedentary Lifestyle
56SEDENTARY TIME
57Standing
58Type 2
59Type 2 diabetes
60VALIDITY
61Walking
62Walking - physiology
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atitleBreaking sitting with light activities vs structured exercise: a randomised crossover study demonstrating benefits for glycaemic control and insulin sensitivity in type 2 diabetes
jtitleDiabetologia
stitleDiabetologia
addtitleDiabetologia
date2017-03
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volume60
issue3
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pages490-498
issn0012-186X
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abstractAIMS/HYPOTHESIS: We aimed to examine the effects of breaking sitting with standing and light-intensity walking vs an energy-matched bout of structured exercise on 24 h glucose levels and insulin resistance in patients with type 2 diabetes. METHODS: In a randomised crossover study, 19 patients with type 2 diabetes (13 men/6 women, 63 ± 9 years old) who were not using insulin each followed three regimens under free-living conditions, each lasting 4 days: (1) Sitting: 4415 steps/day with 14 h sitting/day; (2) Exercise: 4823 steps/day with 1.1 h/day of sitting replaced by moderate- to vigorous-intensity cycling (at an intensity of 5.9 metabolic equivalents [METs]); and (3) Sit Less: 17,502 steps/day with 4.7 h/day of sitting replaced by standing and light-intensity walking (an additional 2.5 h and 2.2 h, respectively, compared with the hours spent doing these activities in the Sitting regimen). Blocked randomisation was performed using a block size of six regimen orders using sealed, non-translucent envelopes. Individuals who assessed the outcomes were blinded to group assignment. Meals were standardised during each intervention. Physical activity and glucose levels were assessed for 24 h/day by accelerometry (activPAL) and a glucose monitor (iPro2), respectively. The incremental AUC (iAUC) for 24 h glucose (primary outcome) and insulin resistance (HOMA2-IR) were assessed on days 4 and 5, respectively. RESULTS: The iAUC for 24 h glucose (mean ± SEM) was significantly lower during the Sit Less intervention than in Sitting (1263 ± 189 min × mmol/l vs 1974 ± 324 min × mmol/l; p = 0.002), and was similar between Sit Less and Exercise (Exercise: 1383 ± 194 min × mmol/l; p = 0.499). Exercise failed to improve HOMA2-IR compared with Sitting (2.06 ± 0.28 vs 2.16 ± 0.26; p = 0.177). In contrast, Sit Less (1.89 ± 0.26) significantly reduced HOMA2-IR compared with Exercise (p = 0.015) as well as Sitting (p = 0.001). CONCLUSIONS/INTERPRETATION: Breaking sitting with standing and light-intensity walking effectively improved 24 h glucose levels and improved insulin sensitivity in individuals with type 2 diabetes to a greater extent than structured exercise. Thus, our results suggest that breaking sitting with standing and light-intensity walking may be an alternative to structured exercise to promote glycaemic control in patients type 2 diabetes. TRIAL REGISTRATION: Clinicaltrials.gov NCT02371239 FUNDING: : The study was supported by a Kootstra grant from Maastricht University Medical Centre+, and the Dutch Heart Foundation. Financial support was also provided by Novo Nordisk BV, and Medtronic and Roche made the equipment available for continuous glucose monitoring.
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pmid27904925
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