24-hour movement behaviours and cardiometabolic health in adults with type 2 diabetes : a comparative cross-sectional and longitudinal analysis

Introduction Meeting the recommended guidelines for physical activity (PA), sedentary behaviour (SB) and sleep, collectively referred to as 24-hour movement behaviours (24h-MBs), is crucial for type 2 diabetes mellitus (T2DM) management and is associated with favourable health outcomes. However, it is suggested that adults with T2DM spend more time in SB and less time in PA compared with adults without diabetes.Objectives This study aims to compare 24h-MBs between adults with and without T2DM (ie, controls with similar characteristics except for having T2DM), investigate how this is associated with cardiometabolic health, and assess changes in 24h-MBs after two years of follow-up (FU) in adults with T2DM.Design Cross-sectional and longitudinal study.Setting Community-dwelling adults with T2DM and controls in Belgium.Primary outcome measures This study took place between September 2021 and December 2023. The 24h-MBs were measured using accelerometers (Actigraph wGT3X+); cardiometabolic variables (adiposity, blood pressure and advanced glycation end-products) were collected in both groups. In adults with T2DM, fasting blood samples were collected at baseline and second FU. Compositional data analysis was used to explore group differences in 24h-MBs using multivariate analysis of variance, and regression models analysed associations with cardiometabolic health. Changes in 24h-MBs over time in adults with T2DM were assessed using a linear mixed model.Results 52 adults with T2DM (mean age 63.2 SD 10.6) and 74 controls (mean age 62.7 SD 9.4) were included in the cross-sectional analysis. The 24h-MBs of adults with T2DM differed significantly from the controls (p=0.026). Adults with T2DM spent significantly less time in light (-34.7 min/day) and moderate to vigorous PA (MVPA) (-24.1 min/day) compared with controls. In adults with T2DM, reallocating 30 min from any behaviour to MVPA was associated with a significant increase in high-density lipoprotein-cholesterol (sleep: 5.05 mg/dL (2.45; 7.80), standardised ...