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Activity Breaks Could Improve Management of T1D Blood Sugar Levels

People with type 1 diabetes (T1D) could maintain better glycaemic control by breaking up sedentary time with bursts of light activity, results from a small study suggested.

Similar benefits have previously been identified for those with type 2 diabetes, but researchers from the University of Sunderland said this was the first time it had been demonstrated in patients with T1D.

To reach their conclusions, the researchers enrolled 15 men and 17 women with T1D aged between 23 and 33 and with HbA1c of 67.9±12.6 mmol/mol. The participants were divided into two groups and completed two 7-hour laboratory sessions over a 2-week period. During one session, participants remained continuously seated and in the other session, they walked about for 3 minutes every half hour, starting 1 hour after each meal.

Diet in both arms of the trial consisted of a standardised mixed-macronutrient breakfast and lunch given 3.5 hours apart, and physical activity, insulin regimen, and start times were also replicated. All 32 participants wore a continuous glucose monitor (Freestyle Libre Pro, Abbott) to measure interstitial glucose concentrations for 48 hours, which included the time spent in the laboratory.

Blood Glucose Reductions

Results from the randomised crossover trial, to be presented this week at the Diabetes UK Professional Conference 2023 in Liverpool, suggested that taking regular walking breaks reduced blood glucose levels over a 48-hour period. 

Mean glucose levels were 8.2±2.6 mmol/L in the cohort that remained seated, against 6.9±1.7 mmol/L in those who had short bouts of activity. Hyperglycaemia (>10.0 mmol/L) was reduced by 15% in the group with exercise breaks, whose time in the target range (3.9 to 10.0 mmol/L) was increased by 13.7%, whilst time exposed to hypoglycaemia (<3.9 mmol/L) was comparable across conditions.

Dr Matthew Campbell, principal investigator in cardiovascular and metabolic medicine at the University of Sunderland, said: "These results provide the first piece of evidence that simply breaking up prolonged periods of time sitting with light-intensity activity can increase the amount of time spent with blood sugar levels in the target range. Importantly, this strategy does not seem to increase the risk of potentially dangerous blood glucose lows, which are a common occurrence with more traditional types of physical activity and exercise.

"Breaking up prolonged sitting with light-intensity activity is something that people can do irrespective of whether they currently exercise or not. For some people, 'activity snacking' could be an important stepping-stone towards more regular physical activity or exercise, whereas for others, it may be a simple and acceptable intervention to help manage blood glucose levels."

The study results were presented as a conference abstract and have yet to be published in a peer-reviewed journal. However, Dr Elizabeth Robertson, director of research at Diabetes UK, which provided the funding, said the findings could provide "a cost-free way to help people with type 1 diabetes manage their blood sugar levels and potentially reduce their risk of future complications". She anticipated "further research to understand the long-term benefits of this approach.