CoChat
Sign Up
Cited by 212Physical Activity and HealthDiabetes Management and ResearchDiabetes Treatment and Management

The DOI matches its Crossref record; 31 of the 32 references it cites were found in a registry or an index.

Breaking sitting with light activities vs structured exercise: a randomised crossover study demonstrating benefits for glycaemic control and insulin sensitivity in type 2 diabetes

Open access
Duvivier, Bernard M. F. M., Schaper, Nicolaas C., Hesselink, Matthijs K. C., van Kan, Linh, Stienen, Nathalie, Winkens, Bjorn, Koster, Annemarie, Savelberg, Hans H. C. M.·2017·Diabetologia
DOI 10.1007/s00125-016-4161-7PMC PMC6518091
Open this paper in CoChat — free accountOpen PDF

Abstract

AIMS/HYPOTHESIS: We aimed to examine the effects of breaking sitting with standing and light-intensity walking vs an energy-matched bout of structured exercise on 24 h glucose levels and insulin resistance in patients with type 2 diabetes. METHODS: In a randomised crossover study, 19 patients with type 2 diabetes (13 men/6 women, 63 ± 9 years old) who were not using insulin each followed three regimens under free-living conditions, each lasting 4 days: (1) Sitting: 4415 steps/day with 14 h sitting/day; (2) Exercise: 4823 steps/day with 1.1 h/day of sitting replaced by moderate- to vigorous-intensity cycling (at an intensity of 5.9 metabolic equivalents [METs]); and (3) Sit Less: 17,502 steps/day with 4.7 h/day of sitting replaced by standing and light-intensity walking (an additional 2.5 h and 2.2 h, respectively, compared with the hours spent doing these activities in the Sitting regimen). Blocked randomisation was performed using a block size of six regimen orders using sealed, non-translucent envelopes. Individuals who assessed the outcomes were blinded to group assignment. Meals were standardised during each intervention. Physical activity and glucose levels were assessed for 24 h/day by accelerometry (activPAL) and a glucose monitor (iPro2), respectively. The incremental AUC (iAUC) for 24 h glucose (primary outcome) and insulin resistance (HOMA2-IR) were assessed on days 4 and 5, respectively. RESULTS: The iAUC for 24 h glucose (mean ± SEM) was significantly lower during the Sit Less intervention than in Sitting (1263 ± 189 min × mmol/l vs 1974 ± 324 min × mmol/l; p = 0.002), and was similar between Sit Less and Exercise (Exercise: 1383 ± 194 min × mmol/l; p = 0.499). Exercise failed to improve HOMA2-IR compared with Sitting (2.06 ± 0.28 vs 2.16 ± 0.26; p = 0.177). In contrast, Sit Less (1.89 ± 0.26) significantly reduced HOMA2-IR compared with Exercise (p = 0.015) as well as Sitting (p = 0.001). CONCLUSIONS/INTERPRETATION: Breaking sitting with standing and light-intensity walking effectively improved 24 h glucose levels and improved insulin sensitivity in individuals with type 2 diabetes to a greater extent than structured exercise. Thus, our results suggest that breaking sitting with standing and light-intensity walking may be an alternative to structured exercise to promote glycaemic control in patients type 2 diabetes. TRIAL REGISTRATION: , and the Dutch Heart Foundation. Financial support was also provided by Novo Nordisk BV, and Medtronic and Roche made the equipment available for continuous glucose monitoring.

Overview

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1007/s00125-016-4161-7

Cites

31 of 31 references verified0 citation errors · 0 not checkable

Statistics

Figures

Fig. 1 Study design. Each participant followed three activity regimens under free-living conditions, each lasting 4 days: (1) Sitting: 14 h sitting/day; (2) Exercise: 1.1 h/day of sitting replaced by moderate- to vigorous-intensity cycling; and (3) Sit Less: 4.7 h/day of sitting replaced by standing (2.5 h) and light-intensity walking (2.2 h), relative to time spent doing these activities in the Sitting regimen
Fig. 1 Study design. Each participant followed three activity regimens under free-living conditions, each lasting 4 days: (1) Sitting: 14 h sitting/day; (2) Exercise: 1.1 h/day of sitting replaced by moderate- to vigorous-intensity cycling; and (3) Sit Less: 4.7 h/day of sitting replaced by standing (2.5 h) and light-intensity walking (2.2 h), relative to time spent doing these activities in the Sitting regimenCC BY · PubMed Central
Fig. 2 Mean 24 h glucose profiles during the last day of each activity regimen (n = 19 individuals). Solid line, Sitting regimen; dashed line, Sit Less regimen; dotted line, Exercise regimen
Fig. 2 Mean 24 h glucose profiles during the last day of each activity regimen (n = 19 individuals). Solid line, Sitting regimen; dashed line, Sit Less regimen; dotted line, Exercise regimenCC BY · PubMed Central
Fig. 3 (a) Twenty-four hour glucose iAUC during the last day of each activity regimen, (b) insulin resistance expressed as HOMA2-IR on the morning after each activity regimen, (c) duration of hyperglycaemia, and (d) maximal reduction in glucose level at 30 min during the last day of each activity regimen. Data are estimated means ± SEM (n = 19 individuals). * p ≤ 0.05, **p < 0.01 vs Sitting regimen; †, p ≤ 0.05 vs Exercise regimen
Fig. 3 (a) Twenty-four hour glucose iAUC during the last day of each activity regimen, (b) insulin resistance expressed as HOMA2-IR on the morning after each activity regimen, (c) duration of hyperglycaemia, and (d) maximal reduction in glucose level at 30 min during the last day of each activity regimen. Data are estimated means ± SEM (n = 19 individuals). * p ≤ 0.05, **p < 0.01 vs Sitting regimen; †, p ≤ 0.05 vs Exercise regimenCC BY · PubMed Central

Verification

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Citations

Cites

Show all 32 references

Research works printed but not linked: 1

  1. World Health Organization (2010) Global recommendations on physical activity for health. WHO Press, Geneva

Cited by

Sorted by citations

See all 212

Related

Metadata

Authors
Duvivier, B. M. F. M., Schaper, N. C., Hesselink, M. K. C., van Kan, L., Stienen, N., Winkens, B., Koster, A., & Savelberg, H. H. C. M.
Affiliations
Maastricht University Medical Centre (NL)
Corresponding author
Duvivier, Bernard M. F. M.
ORCID
Venue
Diabetologia
Publisher
Springer Science and Business Media LLC
Published
2016-11-30
Volume
60
Issue
3
Pages
490-498
ISSN
  • 0012-186X (ISSN-L)
  • 1432-0428
DOI
10.1007/s00125-016-4161-7
PMC
PMC6518091
OpenAlex
W2556532561
Cited by
212
References
32
Citations by year
2026: 8 · 2025: 18 · 2024: 20 · 2023: 22 · 2022: 31 · 2021: 36 · 2020: 28 · 2019: 11 · 2018: 24 · 2017: 12 · 2016: 1
FWCI
12.88
Type
journal article
Language
en
Open access
Licence
Locations
  • Diabetologia (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Research Publications (Maastricht University) (publishedVersion, cc-by)
  • Research Publications (Maastricht University) (submittedVersion, other-oa)
Funders
  • Novo Nordisk B.V.
  • Kootstra Talent Fellowship from the Centre for Research Innovation, Support and Policy of Maastricht University Medical Centre +
  • Roche
  • Maastricht University Medical Centre +
  • Medtronic
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 Treatment and Management
Keywords
type 2 diabetes, sedentary behavior, standing, structured exercise, cycling, glycemic control, insulin resistance, HOMA2-IR, free-living physical activity, step count, accelerometry, glucose monitoring, energy expenditure, free-living conditions, non-pharmacological treatment
MeSH terms
Aged, Blood Glucose, Diabetes Mellitus, Type 2, Female, Humans, Insulin, Insulin Resistance, Male, Middle Aged, Posture, Exercise, Walking, Cross-Over Studies, Lipid Metabolism, Sedentary Behavior

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review