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Interrupting sitting time improves glycaemic control in type 2 diabetes

Interrupting sitting time improves glycaemic control in type 2 diabetes

Publication date: Wednesday, 04 January 2017
Contributor(s): Jeremy Bray

A new study suggests that a ‘Sit Less’ intervention ‒ breaking sitting with standing and light-intensity walking ‒ may be an alternative to structured exercise to promote blood sugar control in patients with type 2 diabetes, giving improved 24-hour glucose levels and improved insulin sensitivity.

Over 90% of the healthy population do not adhere to physical activity guidelines of 150 minutes of moderate to vigorous exercise per week and non-compliance is likely to be even higher in people with type 2 diabetes. The ‘Sit Less’ intervention, which aims to replace sitting time with standing and light-intensity walking, is an alternative approach.

The study involved 19 adults (13 men and 6 women, mean age 63 years) with type 2 diabetes and a mean BMI of 30.5 kg/m2 . They followed three activity regimens – ‘Sitting’, ‘Exercise’ and ‘Sit Less’ – each lasting 4 days. During the ‘Sitting’ regimen participants were restricted to 1 hour/day of walking and 1 hour/day standing. During the ‘Exercise’ regimen approximately 1 hour/day of sitting time was replaced by supervised cycling on an ergometer at the research centre. In the ‘Sit Less’ regimen, 5 hours/day sitting were replaced by 2 hours walking and 3 hours standing, with small bouts of walking and standing throughout the day. The order of the regimens was randomised, and 10 days of usual lifestyle was maintained as a ‘wash-out’ period before and between regimens.

The study found that the use of the ‘Sit Less’ regimen led to significant improvements in insulin sensitivity, mean 24-hour glucose levels, 24-hour glucose excursions, durations of hyperglycaemia and fasting triacylglycerol levels, compared with sitting (Table).

Blood variables Sitting Exercise Sit Less
Glucose (mmol/l) 7.35 7.60 7.29
Insulin (pmol/l) 108 102 95
LDL-C (mmol/l) 3.02 2.96 2.99
Total cholesterol (mmol/l) 5.24 5.10 5.06

Table: Effect of activity regimens on selected blood parameters.

ACTION

These findings suggest that interventions targeting the breaking-up of sitting time may be more practical and effective that interventions involving structured exercise in patients with type 2 diabetes.

Duvivier B, et al. Breaking sitting with light activities vs structured exercise: a randomised crossover study demonstrating benefits for glycaemic control and insulin sensitivity in type 2 diabetes. Diabetologia 2016, published online 17 October. link.springer.com/10.1007/s00125-016-4161-7

Topics covered:
Category: Evidence in Practice
Edition: Volume 1 Number 12 PCCJ Online 2016
Contributor(s): Jeremy Bray

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