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Sedentary time, breaks in sedentary time and metabolic variables in people with newly diagnosed type 2 diabetes
Open accessAbstract
Aims/hypothesis We investigated whether objectively measured sedentary time and interruptions in sedentary time are associated with metabolic factors in people with type 2 diabetes. Methods We studied 528 adults (30-80 years) with newly diagnosed type 2 diabetes, who were participants in a diet and physical activity intervention. Waist circumference (WC), fasting HDL-cholesterol, insulin and glucose levels, HOMA of insulin resistance (HOMA-IR) and physical activity (accelerometer) were measured at baseline and at 6 months follow-up. Linear regression models were used to investigate cross-sectional and longitudinal associations of accelerometer-derived sedentary time and breaks in sedentary time (BST) with metabolic variables. Results In cross-sectional analyses each hour of sedentary time was associated with larger WC (unstandardised regression coefficient [B] [95% CI] 1.89 cm [0.94, 2.83]; p < 0.001), higher insulin (B = 8.22 pmol/l [2.80, 13.65]; p = 0.003) and HOMA-IR (B = 0.42 [0.14, 0.70]; p = 0.004), and lower HDL-cholesterol (B = -0.04 mmol/l [-0.06, -0.01]; p = 0.005). Adjustment for WC attenuated all associations. Each BST was associated with lower WC (B = -0.15 cm [- 0.24, -0.05]; p = 0.003) and there was evidence of a weak linear association with HDL-cholesterol, but no association with insulin levels or HOMA-IR. Volume of sedentary time at baseline predicted HDL-cholesterol (B = -0.05 mmol/l [-0.08, -0.01]; p = 0.007), insulin levels (B = 8.14 pmol/l [0.1.51, 14.78]; p = 0.016) and HOMA-IR (B = 0.49 [0.08, 0.90]; p = 0.020) at 6 months, though not WC. Baseline BST did not substantially predict any metabolic variables at follow-up. No change was seen in sedentary time or BST between baseline and 6 months follow-up. Conclusions/interpretation Higher sedentary time is associated with a poorer metabolic profile in people with type 2 diabetes.
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“More time spent in sedentary behaviors was associated with an increased risk of developing diabetes and poorer metabolic and inflammatory profiles in those with T2DM.”
From The Impact of Physical Activity in Patients With Type 2 Diabetes (2025) · cites this paper as [80]
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“of, or diagnosed T2DM, where objectively measured sedentary behaviour is strongly associatedwithmarkers of insulin resistance, even after adjustment for MVPA [26] and markers of adiposity [6,27].”
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“Previous studies have demonstrated significant associations between daily SB and triacylglycerol [6, 16, 17], HDL-cholesterol [16, 18] and fasting plasma glucose [17].”
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“Notably, the acute experimental findings have mainly resulted from healthy and overweight participants, and the results seem to be less consistent for T2D patients, with one study showing no association between the number of BST with insulin levels or HOMA-IR (Cooper et al., 2012).”
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“In newly diagnosed adults with type 2 diabetes (ages 30–80 years), more time spent in sedentary pursuits has been associated with a larger waist circumference (Cooper et al., 2012), likely reflective of a greater amount of deleterious visceral fat (Amati et al., 2012).”
InfluentialGeidl, W., Carl, J., Cassar, S., Lehbert, N., Mino, E., Wittmann, M., Wagner, R., Schultz, K., & Pfeifer, K. (2019) · Journal of Clinical Medicine · doi:10.3390/jcm8091346 · Cited by 48
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“Recent findings indicate that higher SED-time in individuals with type 2 diabetes is associated with higher metabolic risk, independently of time spent in moderate-tovigorous–intensity PA (MVPA) (7,8), thus suggesting that the biological responses”
BackgroundAssociations of Sedentary Time with Fat Distribution in a High-Risk Population
HENSON, J., EDWARDSON, C. L., MORGAN, B., HORSFIELD, M. A., BODICOAT, D. H., BIDDLE, S. J. H., GORELY, T., NIMMO, M. A., MCCANN, G. P., KHUNTI, K., et al. (2015) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000000572 · Cited by 39
“Therefore, the associations observed for regional and ectopic fat in the present study may help partially explain the relatively strong association between sedentary time and glucose metabolism consistently reported in those with a high risk of, or diagnosed, T2DM (3,4,14).”
BackgroundBailey, D. P., Mugridge, L. H., Dong, F., Zhang, X., & Chater, A. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17124414 · Cited by 39
“In people with T2DM, increased sedentary time is associated with higher levels of CVD risk markers, including hyperglycaemia, insulin resistance, and low high-density lipoprotein cholesterol [8].”
BackgroundSedentary bout durations are associated with abdominal obesity in older adults
Júdice, P. B., Silva, A. M., & Sardinha, L. B. (2015) · The journal of nutrition health & aging · doi:10.1007/s12603-015-0501-4 · Cited by 43
“These findings are indirectly supported by previous studies, that presented breaks in sedentary time to be strongly inversely associated with waist circumference (19, 34, 36, 37) and adds information regarding the minimal thresholds for breaking up sedentary time.”
Farrahi, V., Kangas, M., Kiviniemi, A. M., Puukka, K. S., Korpelainen, R., & Jämsä, T. J. (2021) · Scandinavian Journal of Medicine and Science in Sports · doi:10.1111/sms.13958 · Cited by 45
on behalf of the ADDITION-Plus study team, Lamb, M. J. E., Westgate, K. L., Brage, S., Ekelund, U., Long, G. H., Griffin, S. J., Simmons, R. K., & Cooper, A. (2015) · Diabetologia · doi:10.1007/s00125-015-3756-8 · Cited by 39
“In a cross-sectional analysis of a different cohort of individuals with newly diagnosed diabetes, sedentary time was found to be positively associated with waist circumference; however, the authors found no associations between sedentary time at baseline or change in sedentary time over 6 months of follow-up and any o…”
BackgroundSelf-citationMedina, C., Tolentino‐Mayo, L., López‐Ridaura, R., & Barquera, S. (2017) · PLoS ONE · doi:10.1371/journal.pone.0188518 · Cited by 38
Lahjibi, E., Heude, B., Dekker, J. M., Højlund, K., Laville, M., Nolan, J. J., Oppert, J., & Balkau, B. (2013) · Diabetes & Metabolism · doi:10.1016/j.diabet.2012.12.006 · Cited by 43
“cholesterol, triglycerides, insulin, HOMA-IR and the HOMA insulin-secretion index [15]; in a study of newly-diagnosed type 2 diabetic patients, associations were found with waist”
BackgroundResultInfluentialSedentary Behaviour—A Target for the Prevention and Management of Cardiovascular Disease
Bell, A. C., Richards, J. C., Zakrzewski-Fruer, J. K., Smith, L. R., & Bailey, D. P. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20010532 · Cited by 42
“Similarly, the ROSEBUD (Reduced Occupational Sedentary BehavioUr in type 2 Diabetes) study is assessing the effects of an intervention comprising of a physical activity tracker wristband, text message reminders and nurse-led counselling over 12 months on cardiometabolic outcomes in office workers with T2DM [97].”
BackgroundInfluentialDesk-Based Occupational Sitting Patterns
Ryde, G. C., Brown, H. E., Peeters, G. M. E. E., Gilson, N. D., & Brown, W. J. (2013) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2013.05.018 · Cited by 39
Guo, V., Brage, S., Ekelund, U., Griffin, S., Simmons, R., Amin, R., Baker, G., Betts, M., Dickinson, A., Tcheugui, J. E., et al. (2015) · Diabetic Medicine · doi:10.1111/dme.12886 · Cited by 29
Objectively-measured sedentary time and cardiometabolic health in adults with severe obesity
King, W. C., Chen, J.-Y., Courcoulas, A. P., Mitchell, J. E., Wolfe, B. M., Patterson, E. J., Inabnet, W. B., Dakin, G. F., Flum, D. R., Cook, B. J., et al. (2015) · Preventive Medicine · doi:10.1016/j.ypmed.2015.12.007 · Cited by 39
Daniele, A., Lucas, S. J. E., & Rendeiro, C. (2022) · Frontiers in Physiology · doi:10.3389/fphys.2022.998380 · Cited by 43
“Several studies have reported positive associations between sedentary time and insulin resistance in both adults and children (Sardinha et al., 2008; Cooper et al., 2012; Lahjibi et al., 2013; Kim et al., 2018).”
BackgroundBreaking up sedentary time, physical activity and lipoprotein metabolism
Engeroff, T., Füzéki, E., Vogt, L., & Banzer, W. E. (2017) · Journal of science and medicine in sport · doi:10.1016/j.jsams.2016.11.018 · Cited by 32
Type 2 diabetes sits in a chair
Solomon, T. P. J., & Thyfault, J. P. (2013) · Diabetes Obesity and Metabolism · doi:10.1111/dom.12105 · Cited by 35
“To our knowledge, only one study has objectively measure sedentary time in patients with T2D before and after a lifestyle intervention [46]; however, the authors only found a relationship between sedentary time and fasting insulin not glucose, and following 6 months of physical activity and diet-induced weight loss, n…”
BackgroundYerrakalva, D., Cooper, A., Westgate, K. L., Khaw, K., Wareham, N. J., Brage, S., Griffin, S. J., & Wijndaele, K. (2017) · International Journal of Epidemiology · doi:10.1093/ije/dyx123 · Cited by 32
Self-citationValiani, V., Lauzé, M., Martel, D., Pahor, M., Manini, T. M., Anton, S., & Aubertin-Leheudre, M. (2017) · The Journal of nutrition, health and aging · doi:10.1007/s12603-016-0820-0 · Cited by 30
“While insufficient activity negatively affects their health and quality of life due to its association with chronic diseases (1-2), disability and mortality (3), it also imposes economic burden on the society.”
BackgroundRossen, J., Buman, M. P., Johansson, U., Yngve, A., Ainsworth, B. E., Brismar, K., & Hagströmer, M. (2017) · PLoS ONE · doi:10.1371/journal.pone.0181053 · Cited by 29
“This may be especially beneficial to people with impaired glucose tolerance [8–10].”
BackgroundCurry, W. B., & Thompson, J. L. (2014) · European Journal of Sport Science · doi:10.1080/17461391.2014.957728 · Cited by 30
Huang, B., Hamer, M., CHASTIN, S. F. M., Koster, A., Pearson, N., & Stamatakis, E. A. (2020) · Diabetic Medicine · doi:10.1111/dme.14392 · Cited by 27
activPAL and ActiGraph Assessed Sedentary Behavior and Cardiometabolic Health Markers
Edwardson, C. L., Henson, J. J., Biddle, S., Davies, M. J., Khunti, K. K., Maylor, B. D., & Yates, T. E. (2019) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000002138 · Cited by 28
“Some studies (6–8), but not all (9,10), also suggest that the number of breaks in sedentary behavior per day is an important factor for some aspects of cardiometabolic health.”
BackgroundRecent Trends in Sedentary Time: A Systematic Literature Review
Fang, H., Jing, Y., Chen, J., Wu, Y., & Wan, Y. (2021) · Healthcare · doi:10.3390/healthcare9080969 · Cited by 31
“Over the past decades, scholars worldwide have employed epidemiological research methodologies or combinations of experimental designs [12,13], such as cross-sectional studies [14–16], longitudinal studies [17–19], cohort studies [20–22], intervention studies [23–25], and quasi-experimental studies [26–28], to develop…”
Backgroundfor the Italian Diabetes and Exercise Study 2 (IDES_2) Investigators, Balducci, S., Sacchetti, M., Haxhi, J., Orlando, G., Zanuso, S., Cardelli, P., Cavallo, S., D’Errico, V., Ribaudo, M. C., et al. (2015) · Trials · doi:10.1186/s13063-015-1088-0 · Cited by 25
“Moderate-intensity PA is combined with vigorous-intensity PA into the MVPAs, as participants spend little time in vigorous-intensity PA.”
BackgroundInfluentialPaing, A. C., McMillan, K. A., Kirk, A. F., Collier, A., Hewitt, A., & CHASTIN, S. F. M. (2019) · Journal of science and medicine in sport · doi:10.1016/j.jsams.2019.01.017 · Cited by 24
“Sedentary time is also related to high insulin concentration and insulin resistance in people with newly diagnosed type 2 diabetes.(9) Persistent increase in insulin concentration and insulin resistance related to prolonged sedentary time indicate overworked pancreatic β cells, which could lead to β cells exhaustion.”
BackgroundPositive Orientation as a Predictor of Health Behavior during Chronic Diseases
Kupcewicz, E., Szypulska, A., & Doboszyńska, A. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16183408 · Cited by 26
“showed the negative effect of a sedentary lifestyle, which may be a direct or an indirect cause of death [8].”
BackgroundWang, X., Strizich, G., Hua, S., Sotres‐Alvarez, D., Buelna, C., Gallo, L. C., Gellman, M. D., Mossavar‐Rahmani, Y., O’Brien, M. J., Stoutenberg, M., et al. (2017) · Journal of the American Heart Association · doi:10.1161/jaha.116.004324 · Cited by 25
“Previous studies among individuals with newly diagnosed diabetes mellitus found that sedentary time, but not MVPA, was associated with cardiometabolic biomarkers.(10,11) Relationships of sedentary time and physical activity with reaching major CVD risk control goals among individuals with diabetes mellitus remain unkn…”
BackgroundSygit, K., Sygit, M., Wojtyła-Buciora, P., Lubiniec, O., Stelmach, W., & Krakowiak, J. (2018) · Annals of Agricultural and Environmental Medicine · doi:10.26444/aaem/99177 · Cited by 24
“Important health risks include nicotinism, drug addiction, alcoholism, obesity, (currently, there are a billion overweight adults and over 300 million obese worldwide, and the problem of excessive fat tissue also affects more and more people in Poland), chronic diseases, disorders of the motor system, and risky sexual…”
BackgroundChatziralli, I., Sergentanis, T. Ν., Crosby‐Nwaobi, R., Winkley, K., Eleftheriadis, H., Ismail, K., Amiel, S. A., & Sivaprasad, S. (2017) · Investigative Ophthalmology & Visual Science · doi:10.1167/iovs.17-21713 · Cited by 26
Li, C., Beech, B. M., Crume, T., D'Agostino, R. B., Dabelea, D., Kaar, J. L., Liese, A. D., Mayer‐Davis, E. J., Pate, R. R., Pettitt, D. J., et al. (2014) · Pediatric Diabetes · doi:10.1111/pedi.12163 · Cited by 23
“However, change in sedentary time measured by accelerometer was not associated with HDL-c in a longitudinal analysis of adults with T2D (37), similar to what we observed.”
BackgroundResultMańkiewicz-Żurawska, I., & Jarosz-Chobot, P. A. (2019) · Pediatric Endocrinology Diabetes and Metabolism · doi:10.5114/pedm.2019.85817 · Cited by 21
Effects of breaking up sedentary time with “chair squats” on postprandial metabolism
HAWARI, N. S. A., Wilson, J., & Gill, J. M. R. (2018) · Journal of Sports Sciences · doi:10.1080/02640414.2018.1500856 · Cited by 21
Sedentary Time and MRI‐Derived Measures of Adiposity in Active Versus Inactive Individuals
Henson, J. J., Edwardson, C. L., Morgan, B., Horsfield, M. A., Khunti, K. K., Davies, M. J., & Yates, T. E. (2017) · Obesity · doi:10.1002/oby.22034 · Cited by 22
“Objectively measured sedentary behaviour quantified using an accelerometer is strongly associated with markers of insulin resistance (14-16),”
MethodAn, K. H., Han, K. A., Sohn, T. S., Park, I. B., Kim, H. J., Moon, S. D., & Min, K. W. (2019) · Diabetes & Metabolism Journal · doi:10.4093/dmj.2019.0029 · Cited by 21
Miyamoto, T., Fukuda, K., Oshima, Y., & Moritani, T. (2017) · The Physician and Sportsmedicine · doi:10.1080/00913847.2017.1350084 · Cited by 19
“Patients with type 2 diabetes, however, spend less than 5% of the day engaged in MVPA including LPA [6,7] and are”
BackgroundIndelicato, L., Dauriz, M., Bacchi, E., Donà, S., Santi, L., Negri, C., Cacciatori, V., Bonora, E., Nouwen, A., & Moghetti, P. (2018) · Acta Diabetologica · doi:10.1007/s00592-018-1132-0 · Cited by 20
“Other studies have shown that sedentary behaviour per se adversely affects individual health, independent of the amount of physical activity in the general population [28] and in individuals with T2D [29, 30].”
BackgroundPsychological well-being and restorative biological processes: HDL-C in older English adults
Soo, J., Kubzansky, L. D., Chen, Y., Zevon, E. S., & Boehm, J. K. (2018) · Social Science & Medicine · doi:10.1016/j.socscimed.2018.05.025 · Cited by 21
Arora, T., Chen, M. Z., Omar, O., Cooper, A. R., Andrews, R. C., & Taheri, S. (2015) · Therapeutic Advances in Endocrinology and Metabolism · doi:10.1177/2042018815616549 · Cited by 18
“Data were downloaded and average counts per minute (cpm) was derived from all days that the pedometer was worn [Cooper et al. 2012].”
MethodSelf-citationThe Impact of Physical Activity in Patients With Type 2 Diabetes
Bassin, S. R., & Srinath, R. (2025) · American Journal of Lifestyle Medicine · doi:10.1177/15598276231180541 · Cited by 17
Bailey, D. P., Edwardson, C. L., Pappas, Y., Dong, F., Hewson, D. J., Biddle, S., Brierley, M. L., & Chater, A. (2021) · Pilot and Feasibility Studies · doi:10.1186/s40814-021-00816-0 · Cited by 18
Advancing the Science of Sedentary Behavior Measurement
Marshall, S. J., & Merchant, G. (2013) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2012.11.001 · Cited by 18
Metadata
- Authors
- Cooper, A. R., Sebire, S., Montgomery, A. A., Peters, T. J., Sharp, D. J., Jackson, N., Fitzsimons, K., Dayan, C. M., & Andrews, R. C.
- Affiliations
- University of Bristol (GB)
- Cardiff University (GB)
- Corresponding author
- Cooper, A. R.
- Venue
- Diabetologia
- Published
- 2011-12-14
- Volume
- 55
- Issue
- 3
- Pages
- 589-599
- ISSN
- 0012-186X (ISSN-L)
- 1432-0428
- OpenAlex
- W2171170053
- Cited by
- 195
- References
- 41
- Citations by year
- 2026: 4 · 2025: 1 · 2024: 15 · 2023: 10 · 2022: 5 · 2021: 12 · 2020: 14 · 2019: 12 · 2018: 14 · 2017: 26 · 2016: 16 · 2015: 23 · 2014: 20 · 2013: 20 · 2012: 3
- FWCI
- 8.87
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Diabetologia (publishedVersion)
- PubMed (publishedVersion)
- Bristol Research (University of Bristol) (publishedVersion)
- University of Birmingham Research Portal (University of Birmingham) (submittedVersion, other-oa)
- Funders
- National Institute for Health and Care Research (PB-PG-0610-22352)
- Economic and Social Research Council (ES/G007543/1)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- sedentary time, metabolic risk factors, waist circumference, insulin resistance, HOMA-IR, HDL cholesterol, insulin levels, physical activity, newly diagnosed diabetes, cardiovascular risk, glycemic control, HbA1c
- MeSH terms
- Adult, Aged, Aged, 80 and over, Cross-Sectional Studies, Diabetes Mellitus, Type 2, England, Female, Humans, Insulin, Insulin Resistance, Cholesterol, HDL, Longitudinal Studies, Male, Middle Aged, Motor Activity, Patient Compliance, Time Factors, Cohort Studies, Body Mass Index, Overweight, Young Adult, Sedentary Behavior
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