Replacing sedentary time with sleep and physical activity: associations with physical function and wellbeing in Type 2 diabetes

Alix Covenant; Thomas Yates; Alex V Rowlands; Paddy C Dempsey; Charlotte L Edwardson; Andrew P Hall; Melanie J Davies; Joseph Henson

doi:10.1016/j.diabres.2024.111886

Replacing sedentary time with sleep and physical activity: associations with physical function and wellbeing in Type 2 diabetes

Diabetes Res Clin Pract. 2024 Nov:217:111886. doi: 10.1016/j.diabres.2024.111886. Epub 2024 Oct 5.

Authors

Alix Covenant¹, Thomas Yates², Alex V Rowlands³, Paddy C Dempsey⁴, Charlotte L Edwardson², Andrew P Hall⁵, Melanie J Davies², Joseph Henson²

Affiliations

¹ Diabetes Research Centre, College of Life Sciences, University of Leicester, UK and NIHR Leicester Biomedical Research Centre, UK. Electronic address: [email protected].
² Diabetes Research Centre, College of Life Sciences, University of Leicester, UK and NIHR Leicester Biomedical Research Centre, UK; Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, UK.
³ Diabetes Research Centre, College of Life Sciences, University of Leicester, UK and NIHR Leicester Biomedical Research Centre, UK; Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, UK; Alliance for Research in Exercise, Nutrition and Activity (ARENA), UniSA Allied Health and Human Performance, University of South Australia, Adelaide, Australia.
⁴ Diabetes Research Centre, College of Life Sciences, University of Leicester, UK and NIHR Leicester Biomedical Research Centre, UK; Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, UK; Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia; Baker Heart & Diabetes Institute, Melbourne, Victoria, Australia; MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK.
⁵ Hanning Sleep Laboratory, Leicester General Hospital, University Hospitals of Leicester NHS Trust, UK.

PMID: 39369857
DOI: 10.1016/j.diabres.2024.111886

Abstract

Aims: To examine the associations of substituting sedentary behaviour (SB) for sleep, light physical activity (LPA) or moderate-to-vigorous physical activity (MVPA) with physical function and wellbeing.

Methods: Cross-sectional data from 808 adults with Type 2 Diabetes Mellitus, (T2DM) were included. 24-hour behaviours were ascertained through accelerometery. Isotemporal substitution was used to estimate the theoretical substitution of SB for other 24-hour behaviours on associations with physical function and wellbeing markers.

Results: Reallocating 30 min of SB to sleep was beneficially associated with 1.0% (95% CI: 0.1-1.9) higher sit-to-stand-60 (STS60) and 1.2% (0.1-2.3) Duke Activity Status Index (DASI) scores, 3.6% (1.5-5.5) lower Patient Hospital Questionnaire-9 (PHQ9) and 1.9% lower (0.1-3.7) Diabetes Distress scores. Whilst substituting SB with MVPA was associated with 3.8% (2.2-5.4) higher STS60 and 3.9% (2.0-5.9) DASI scores, and 4.7% (0.3-9.0) lower PHQ9 score. Replacing SB with LPA was associated with 4.1% (1.0-7.1) lower PHQ9 score.

Conclusion: In adults with T2DM, theoretically replacing SB with sleep and physical activity, particularly MVPA is beneficially associated with markers of physical function and wellbeing. For wellbeing, associations for sleep were comparable (depression), or greater (diabetes distress), than for MVPA.

Keywords: Depression; Isotemporal diabetes distress; Physical function; Self-compassion; Sleep; T2DM.

MeSH terms

Accelerometry
Adult
Aged
Cross-Sectional Studies
Diabetes Mellitus, Type 2* / physiopathology
Exercise* / physiology
Female
Humans
Male
Middle Aged
Sedentary Behavior*
Sleep* / physiology