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Sustained decreases in sedentary time and increases in physical activity are associated with preservation of estimated β-cell function in individuals with type 2 diabetes

  • Author Footnotes
    1 Stefano Balducci and Jonida Haxhi contributed equally to this work.
    Stefano Balducci
    Footnotes
    1 Stefano Balducci and Jonida Haxhi contributed equally to this work.
    Affiliations
    Department of Clinical and Molecular Medicine, University of Rome La Sapienza, Rome, Italy

    Diabetes Unit, Sant’Andrea University Hospital, Rome, Italy

    Metabolic Fitness Association, Monterotondo, Rome, Italy
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  • Author Footnotes
    1 Stefano Balducci and Jonida Haxhi contributed equally to this work.
    Jonida Haxhi
    Footnotes
    1 Stefano Balducci and Jonida Haxhi contributed equally to this work.
    Affiliations
    Department of Clinical and Molecular Medicine, University of Rome La Sapienza, Rome, Italy

    Diabetes Unit, Sant’Andrea University Hospital, Rome, Italy

    Metabolic Fitness Association, Monterotondo, Rome, Italy
    Search for articles by this author
  • Martina Vitale
    Affiliations
    Department of Clinical and Molecular Medicine, University of Rome La Sapienza, Rome, Italy

    Diabetes Unit, Sant’Andrea University Hospital, Rome, Italy
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  • Lorenza Mattia
    Affiliations
    Department of Clinical and Molecular Medicine, University of Rome La Sapienza, Rome, Italy

    Diabetes Unit, Sant’Andrea University Hospital, Rome, Italy
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  • Lucilla Bollanti
    Affiliations
    Department of Clinical and Molecular Medicine, University of Rome La Sapienza, Rome, Italy

    Diabetes Unit, Sant’Andrea University Hospital, Rome, Italy
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  • Francesco Conti
    Affiliations
    Department of Clinical and Molecular Medicine, University of Rome La Sapienza, Rome, Italy

    Diabetes Unit, Sant’Andrea University Hospital, Rome, Italy
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  • Patrizia Cardelli
    Affiliations
    Department of Clinical and Molecular Medicine, University of Rome La Sapienza, Rome, Italy

    Laboratory of Clinical Chemistry, Sant’Andrea University Hospital, Rome, Italy
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  • Massimo Sacchetti
    Affiliations
    Department of Human Movement and Sport Sciences, University of Rome ‘Foro Italico’, Rome, Italy
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  • Author Footnotes
    2 Previous address: Department of Human Movement and Sport Sciences, University of Rome ‘Foro Italico’, Rome, Italy.
    Giorgio Orlando
    Footnotes
    2 Previous address: Department of Human Movement and Sport Sciences, University of Rome ‘Foro Italico’, Rome, Italy.
    Affiliations
    Research Centre for Musculoskeletal Science & Sports Medicine, Department of Life Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK
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  • Author Footnotes
    3 Centre for Human Performance and Sport, University of Greenwich, Chatham Maritime, UK.
    Silvano Zanuso
    Footnotes
    3 Centre for Human Performance and Sport, University of Greenwich, Chatham Maritime, UK.
    Affiliations
    Centre for Applied Biological & Exercise Sciences, Faculty of Health & Life Sciences, Coventry University, Coventry, UK
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  • Author Footnotes
    4 Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, S. Maria Imbaro, Italy.
    Antonio Nicolucci
    Footnotes
    4 Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, S. Maria Imbaro, Italy.
    Affiliations
    Centre for Outcomes Research and Clinical Epidemiology (CORESEARCH), Pescara, Italy
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  • Giuseppe Pugliese
    Correspondence
    Corresponding author at: Department of Clinical and Molecular Medicine, “La Sapienza” University, Via di Grottarossa, 1035-1039 - 00189 Rome, Italy.
    Affiliations
    Department of Clinical and Molecular Medicine, University of Rome La Sapienza, Rome, Italy

    Diabetes Unit, Sant’Andrea University Hospital, Rome, Italy
    Search for articles by this author
  • for the Italian Diabetes, Exercise Study 2 IDES_2 Investigators
    Author Footnotes
    5 See Supplementary Material for a complete list of the IDES_2 Investigators.
  • Author Footnotes
    1 Stefano Balducci and Jonida Haxhi contributed equally to this work.
    2 Previous address: Department of Human Movement and Sport Sciences, University of Rome ‘Foro Italico’, Rome, Italy.
    3 Centre for Human Performance and Sport, University of Greenwich, Chatham Maritime, UK.
    4 Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, S. Maria Imbaro, Italy.
    5 See Supplementary Material for a complete list of the IDES_2 Investigators.
Published:October 31, 2022DOI:https://doi.org/10.1016/j.diabres.2022.110140

      Abstract

      Aims

      In the Italian Diabetes and Exercise Study_2, a counselling intervention produced modest but sustained increments in moderate-to vigorous-intensity physical activity (MVPA), with reallocation of sedentary-time (SED-time) to light-intensity physical activity (LPA). This post hoc analysis evaluated the impact of intervention on estimated β-cell function and insulin sensitivity.

      Methods

      Patients with type 2 diabetes were randomized to one-month counselling once-a-year or standard care for 3 years. The HOmeostatic Model Assessment-2 (HOMA-2) method was used for estimating indices of β-cell function (HOMA-B%), insulin sensitivity (HOMA-S%), and insulin resistance (HOMA-IR); the disposition index (DI) was estimated as HOMA-β%/HOMA-IR; MVPA, LPA, and SED-time were objectively measured by accelerometer.

      Results

      HOMA-B% and DI decreased in control group, whereas HOMA-B% remained stable and DI increased in intervention group. Between-group differences were significant for almost all insulin secretion and sensitivity indices. Changes in HOMA-B% and DI correlated with SED-time, MVPA and LPA. Changes in HOMA-B%, DI, and all indices were independently predicted by changes in SED-time (or LPA), MVPA, and BMI (or waist circumference), respectively.

      Conclusions

      In individuals with type 2 diabetes, increasing MVPA, even without achieving the recommended target, is effective in maintaining estimated β-cell function if sufficient amounts of SED-time are reallocated to LPA.

      Keywords

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