Association of Habitual Daily Physical Activity With Glucose Tolerance and β-Cell Function in Adults With Impaired Glucose Tolerance or Recently Diagnosed Type 2 Diabetes From the Restoring Insulin Secretion (RISE) Study

• Published in: Diabetes care Vol. 42; no. 8; pp. 1521 - 1529
• Main Authors: Temple, Karla A, Tjaden, Ashley H, Atkinson, Karen M, Barengolts, Elena, Hannon, Tamara S, Mather, Kieren J, Utzschneider, Kristina M, Edelstein, Sharon L, Ehrmann, David A, Mokhlesi, Babak
• Format: Journal Article
• Language: English
• Published: United States American Diabetes Association 01.08.2019
• Subjects: Accelerometers; Adult; Adults; Blood Glucose - metabolism; C-Peptide - blood; Cardiovascular and Metabolic Risk; Chromium; Cross-Sectional Studies; Diabetes; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - diagnosis; Diabetes Mellitus, Type 2 - physiopathology; Diabetes Mellitus, Type 2 - therapy; Drug development; Exercise; Exercise - physiology; Exercise Therapy - methods; Fasting; Female; Glucose; Glucose Clamp Technique; Glucose Intolerance - blood; Glucose Intolerance - physiopathology; Glucose Intolerance - therapy; Glucose tolerance; Glucose Tolerance Test; Humans; Hypoglycemic Agents - therapeutic use; Insulin; Insulin - blood; Insulin Resistance - physiology; Insulin secretion; Insulin Secretion - physiology; Insulin-Secreting Cells - metabolism; Insulin-Secreting Cells - physiology; Laboratory testing; Male; Medical diagnosis; Medication Adherence; Middle Aged; Peptides; Physical activity; Research design; Secretion; Sensitivity; Steady state; Time Factors; Wrist
• ISSN: 0149-5992; 1935-5548
• DOI: 10.2337/dc19-0538

We examined the relationship between habitual daily physical activity and measures of glucose tolerance, insulin sensitivity, and β-cell responses in adults with impaired glucose tolerance (IGT) or drug-naive, recently diagnosed type 2 diabetes. Participants included 230 adults (mean ± SD age 54.5 ± 8.5 years, BMI 35 ± 5.5 kg/m ; 42.6% women) who underwent a 3-h oral glucose tolerance test (OGTT) and hyperglycemic clamp. Wrist accelerometers worn for 7 consecutive days measured total physical activity counts (TAC) (daily mean 233,460 [∼50th percentile for age]). We evaluated whether TAC was associated with fasting plasma glucose, OGTT 2-h plasma glucose or glucose incremental area under the curve (G-iAUC), hyperglycemic clamp measures of insulin sensitivity (steady-state glucose infusion rate/insulin [M/I]) and β-cell responses (acute C-peptide response to glucose, steady-state C-peptide, and maximal β-cell response), and OGTT C-peptide index (ΔC-peptide /Δglucose ). After adjustments for confounders, there was no association of TAC with fasting plasma glucose, 2-h glucose, or G-iAUC. Higher TAC was associated with higher insulin sensitivity (M/I). After adjusting for M/I, higher TAC was not associated with measures of β-cell response. In adults with IGT or drug-naive, recently diagnosed type 2 diabetes, higher levels of habitual physical activity are associated with higher insulin sensitivity. Further studies are needed to understand why higher levels of physical activity are not associated with better β-cell response.