Effect of Interrupting Prolonged Sitting with Frequent Activity Breaks on Postprandial Glycemia and Insulin Sensitivity in Adults with Type 1 Diabetes on Continuous Subcutaneous Insulin Infusion Therapy: A Randomized Crossover Pilot Trial

Robyn Larsen; Frances Taylor; Paddy C Dempsey; Melitta McNarry; Kym Rickards; Parneet Sethi; Ashleigh Homer; Neale Cohen; Neville Owen; Kavita Kumareswaran; Richard MacIsaac; Sybil A McAuley; David O'Neal; David W Dunstan

doi:10.1089/dia.2024.0146

Effect of Interrupting Prolonged Sitting with Frequent Activity Breaks on Postprandial Glycemia and Insulin Sensitivity in Adults with Type 1 Diabetes on Continuous Subcutaneous Insulin Infusion Therapy: A Randomized Crossover Pilot Trial

Diabetes Technol Ther. 2024 Nov 7. doi: 10.1089/dia.2024.0146. Online ahead of print.

Authors

Robyn Larsen^{1

2}, Frances Taylor³, Paddy C Dempsey^{2

4

5

6}, Melitta McNarry⁷, Kym Rickards², Parneet Sethi², Ashleigh Homer⁸, Neale Cohen⁹, Neville Owen^{2

10}, Kavita Kumareswaran¹¹, Richard MacIsaac^{3

12

13}, Sybil A McAuley^{6

14}, David O'Neal^{3

12

13}, David W Dunstan^{2

15}

Affiliations

¹ Faculty of Science, The University of Melbourne, Melbourne, Australia.
² Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia.
³ Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia.
⁴ MRC Epidemiological Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom.
⁵ Diabetes Research Centre, University of Leicester, Leicester, United Kingdom.
⁶ School of Public Health and Preventative Medicine, Monash University, Melbourne, Australia.
⁷ Applied Sports, Technology, Exercise and Medicine Research Centre, Swansea University, Swansea, United Kingdom.
⁸ Sports Performance, Recovery, Injury and New Technologies Research Centre, School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Australia.
⁹ Head of Clinical Diabetes, Baker Heart and Diabetes Institute, Melbourne, Australia.
¹⁰ Swinburne Centre for Urban Transitions, Swinburne University, Melbourne, Australia.
¹¹ The Endocrine and Diabetes Centre, Cabrini Hospital and Monash University, Melbourne, Australia.
¹² Department of Endocrinology and Diabetes, St Vincent's Hospital, Melbourne, Australia.
¹³ Australian Centre for Accelerating Diabetes Innovations, The University of Melbourne, Australia.
¹⁴ Department of Endocrinology and Diabetes, The Alfred, Melbourne, Australia.
¹⁵ Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Australia.

PMID: 39506625
DOI: 10.1089/dia.2024.0146

Abstract

Objective: This study examined acute effects of interrupting prolonged sitting with short activity breaks on postprandial glucose/insulin responses and estimations of insulin sensitivity in adults with type 1 diabetes (T1D). Method: In a randomized crossover trial, eight adults (age = 46 ± 14 years [mean ± SD], body mass index [BMI] = 27.2 ± 3.8 kg/m²) receiving continuous subcutaneous insulin infusion (CSII) therapy completed two 6-h conditions as follows: uninterrupted sitting (SIT) and sitting interrupted with 3-min bouts of simple resistance activities (SRAs) every 30 min. Basal and bolus insulin were standardized across conditions except in cases of hypoglycemia. Postprandial responses were assessed using incremental area-under-the-curve (iAUC) and total AUC (tAUC) from half-hourly venous sampling. Meal-based insulin sensitivity determined from glucose sensor and insulin pump (S_i^SP) was assessed from flash continuous glucose monitor and insulin pump data. Outcomes were analyzed using mixed models adjusted for sex, BMI, treatment order, and preprandial values. Results: Glucose iAUC did not differ by condition (SIT: 19.8 ± 3.0 [estimated marginal means ± standard error] vs. SRA: 14.4 ± 3.0 mmol.6 h.L^-1; P = 0.086). Despite CSII being standardized between conditions, insulin iAUC was higher in SRA compared to SIT (137.1 ± 22.7 vs. 170.9 ± 22.7 mU.6 h.L^-1; P < 0.001). This resulted in a lower glucose response relative to the change in plasma insulin in SRA (tAUCglu/tAUCins: 0.32 ± 0.02 vs. 0.40 ± 0.02 mmol.mU^-1; P = 0.03). Si^SP was also higher at dinner following the SRA condition, with no between-condition differences at breakfast or lunch. Conclusion: Regularly interrupting prolonged sitting in T1D may increase plasma insulin and improve insulin sensitivity when meals and CSII are standardized. Future studies should explore underlying mechanistic determinants and the applicability of findings to those on multiple daily injections. Trial Registration: Australian and New Zealand Clinical Trial Registry Identifier-ACTRN12618000126213 (www.anzctr.org.au).

Keywords: glucose control; insulin therapy; sedentary behavior; type 1 diabetes.