Purpose: A healthy lifestyle is associated with beneficial health effects in managing type 2 diabetes mellitus (T2DM). Important lifestyle behaviors, i.e. sleep, sedentary behavior (SB), and physical activity (PA), impact T2DM disease-specific characteristics. These behaviors are often investigated separately. A recent shift in research emphasizes the importance of considering these behaviors as part of a 24-hour day. Therefore, the aim of this study is to explore these 24-hour movement behaviors (24h-MBs) in T2DM adults.

Methods: This study currently includes data of 10 T2DM adults (mean age: 66.9y, 60% men; mean years T2DM: 9.2y) and 23 adults with normal glucose levels(NGL) (mean age: 59.35y, 40% men). Participants’ 24h-MBs were measured by actigraphy (Actigraph wGT3X+). All 24h-MBs were analyzed between adults with T2DM and NGL on an average day and on weekdays and weekend days separately. Independent Sample T-tests, Mann-Whitney U Tests, and One Sample T-tests were conducted.

Results: Means for 24h-MBs on an average day in T2DM adults were 635.26 (±76.61) min/SB; 275.7 (±63.05) minutes of light PA (min/LPA); 9.51 (±9.24) minutes of moderate to vigorous PA (min/MVPA); 6475.76 (±2366.39) step counts; 96.87% (±0.97) sleep efficiency; 478.29 (±26.21) minutes Total Sleep Time (min/TST); 12.55 (±4.29) minutes Wake After Sleep Onset (min/WASO). Means for the NGL adults were 586.55 (±68.54); 314.48 (±70.49); 18.41 (±13.70); 8048.16 (±2804.57); 95.70 (±2.11); 468.45 (±40.82); 18.24 (±9.04), respectively. On an average day, T2DM adults spent significantly less time in min/MVPA and min/WASO compared to NGL adults (p=0.042; p=0.023). On an average weekend day, T2DM adults spent significantly more time in min/SB and less time in min/LPA compared to NGL adults (p=0.004; p=0.009). Both groups did not meet the current 24h-MB guidelines of 150 min of MVPA/week  (both p<0.001 ) and a maximum of 8 hours of SB/day (both p<0.001). Meeting the sleep guideline did not significant differ.

Conclusion: These preliminary results showed high levels of min/SB and low levels of min/MVPA in both groups, which were more pronounced in the T2DM group. Recruitment is ongoing which will result in additional analyses in a larger sample. Personal, cardiometabolic and environmental correlates will be explored in the following months.

Background: The aim of this study was to investigate the prevalence of insomnia (symptoms) in people with T2D and to assess the association with metabolic outcomes cross-sectionally and after one year follow-up, and assess the mediating role of lifestyle factors.

Methods: We used data of 1272 participants with T2D, 63.4% men and aged 68.7±9 years. Insomnia symptoms and insomnia were defined based on the Insomnia Severity Index combined with use of sleep medication. Metabolic outcomes included annual levels of HbA1c, fasting plasma glucose, LDL, HDL, triglycerides, blood pressure and BMI. Stratified for comorbidities, associations between (symptoms of) insomnia and (1-year change in) metabolic outcomes were assessed using linear regression analyses, adjusted for age, sex, diabetes duration and educational level. Mediation analyses were conducted for physical activity, smoking and alcohol intake as mediators.

Results: The prevalence of insomnia symptoms and insomnia was 21.6% and 13.6% respectively. In people with T2D and comorbidities (n=759), insomnia symptoms were associated with higher levels of glucose 0.43 mmol/l (0.03:0.82) and lower levels of LDL -0.18 mmol/l (-0.36:-0.00), compared to no insomnia. No association was observed in people without comorbidities (n=513). Over 1 year, in people with comorbidities insomnia symptoms were associated with an increase in HbA1c of 0.12% (-0.03:0.3) as well as a decrease in HDL levels of -0.04 mmol/l (-0.06:-0.01), compared to no insomnia. Additionally, in people with T2D and comorbidities, insomnia was associated with an increase in triglyceride levels of 0.08 mmol/l (0.01:0.14), compared to no insomnia. No statistically significant associations were observed for the other metabolic outcomes and no mediation by lifestyle factors.

Conclusions: Overall, our study showed that about a third of people with T2D experience insomnia (symptoms) and it being associated with small but deleterious (changes in) metabolic outcomes, especially in those with comorbidities.