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Physical behaviors and chronotype in people with type 2 diabetes.

ABSTRACT: INTRODUCTION:Previous investigations have suggested that evening chronotypes may be more susceptible to obesity-related metabolic alterations. However, whether device-measured physical behaviors differ by chronotype in those with type 2 diabetes (T2DM) remains unknown. RESEARCH DESIGN AND METHODS:This analysis reports data from the ongoing Chronotype of Patients with Type 2 Diabetes and Effect on Glycaemic Control (CODEC) observational study. Eligible participants were recruited from both primary and secondary care settings in the Midlands area, UK. Participants were asked to wear an accelerometer (GENEActiv, ActivInsights, Kimbolton, UK) on their non-dominant wrist for 7 days to quantify different physical behaviors (sleep, sedentary, light, moderate-to-vigorous physical activity (MVPA), intensity gradient, average acceleration and the acceleration above which the most active continuous 2, 10, 30 and 60 min are accumulated). Chronotype preference (morning, intermediate or evening) was assessed using the Morningness-Eveningness Questionnaire. Multiple linear regression analyses assessed whether chronotype preference was associated with physical behaviors and their timing. Evening chronotypes were considered as the reference group. RESULTS:635 participants were included (age=63.8±8.4 years, 34.6% female, body mass index=30.9±5.1 kg/m2). 25% (n=159) of the cohort were morning chronotypes, 52% (n=330) intermediate and 23% (n=146) evening chronotypes. Evening chronotypes had higher sedentary time (28.7 min/day, 95% CI 8.6 to 48.3) and lower MVPA levels (-9.7 min/day, -14.9 to -4.6) compared to morning chronotypes. The intensity of the most active continuous 2-60 min of the day, average acceleration and intensity gradient were lower in evening chronotypes. The timing of physical behaviors also differed across chronotypes, with evening chronotypes displaying a later sleep onset and consistently later physical activity time. CONCLUSIONS:People with T2DM lead a lifestyle characterized by sedentary behaviors and insufficient MVPA. This may be exacerbated in those with a preference for 'eveningness' (ie, go to bed late and get up late).

SUBMITTER: Henson J

PROVIDER: S-EPMC7368491 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature

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Physical behaviors and chronotype in people with type 2 diabetes.

Henson Joseph J Rowlands Alex V AV Baldry Emma E Brady Emer M EM Davies Melanie J MJ Edwardson Charlotte L CL Yates Thomas T Hall Andrew P AP

BMJ open diabetes research & care 20200701 1

<h4>Introduction</h4>Previous investigations have suggested that evening chronotypes may be more susceptible to obesity-related metabolic alterations. However, whether device-measured physical behaviors differ by chronotype in those with type 2 diabetes (T2DM) remains unknown.<h4>Research design and methods</h4>This analysis reports data from the ongoing Chronotype of Patients with Type 2 Diabetes and Effect on Glycaemic Control (CODEC) observational study. Eligible participants were recruited f ...[more]

PMID: 32675292

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Project description:BackgroundComplications due to type 2 diabetes (T2D) can be mitigated through proper self-management that can positively change health behaviors. Technological tools are available to help people living with, or at risk of developing, T2D to manage their condition, and such tools provide a large repository of patient-generated health data (PGHD). Analytics can provide insights into the health behaviors of people living with T2D.ObjectiveThe aim of this review is to investigate what can be learned about the health behaviors of those living with, or at risk of developing, T2D through analytics from PGHD.MethodsA scoping review using the Arksey and O'Malley framework was conducted in which a comprehensive search of the literature was conducted by 2 reviewers. In all, 3 electronic databases (PubMed, IEEE Xplore, and ACM Digital Library) were searched using keywords associated with diabetes, behaviors, and analytics. Several rounds of screening using predetermined inclusion and exclusion criteria were conducted, after which studies were selected. Critical examination took place through a descriptive-analytical narrative method, and data extracted from the studies were classified into thematic categories. These categories reflect the findings of this study as per our objective.ResultsWe identified 43 studies that met the inclusion criteria for this review. Although 70% (30/43) of the studies examined PGHD independently, 30% (13/43) combined PGHD with other data sources. Most of these studies used machine learning algorithms to perform their analysis. The themes identified through this review include predicting diabetes or obesity, deriving factors that contribute to diabetes or obesity, obtaining insights from social media or web-based forums, predicting glycemia, improving adherence and outcomes, analyzing sedentary behaviors, deriving behavior patterns, discovering clinical correlations from behaviors, and developing design principles.ConclusionsThe increased volume and availability of PGHD have the potential to derive analytical insights into the health behaviors of people living with T2D. From the literature, we determined that analytics can predict outcomes and identify granular behavior patterns from PGHD. This review determined the broad range of insights that can be examined through PGHD, which constitutes a unique source of data for these applications that would not be possible through the use of other data sources.

Project description:BackgroundSelf-care behaviors in people living with type 2 diabetes are important to achieving optimal glycemic control. Major depression in type 2 diabetes is associated with decreased adherence to self-care behaviors. The association between subthreshold depression and self-care behaviors, however, has not previously been systematically reviewed. The objective of this review is to determine the association between subthreshold depression and self-care behaviors.MethodsA systematic search was performed in five electronic databases that included MEDLINE, EMBASE, PsycINFO, Emcare, and CINAHL. Any observational studies in adults with type 2 diabetes, investigating the association between subthreshold depression and any self-care behaviors, were included in the review. Qualitative studies, review articles, and gray literature were excluded. Two reviewers independently completed the title and abstract and full-text screening, appraised the study quality, and extracted the data. A third reviewer resolved any discrepancies between the reviewers if needed. Included articles were critically appraised using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist. Meta-analyses were not conducted because criteria for conducting such analyses were not met.ResultsA total of 6408 articles were identified through the database searching. After the abstract and full-text review, two articles met the inclusion criteria. One of the included study was cross-sectional while the other was a longitudinal study. Both studies showed inconsistent findings in the association between subthreshold depression and self-care behaviors. Important risks of bias were identified in the included studies.DiscussionThe evidence from the two included studies on a possible association between subthreshold depression and self-care behaviors in adults with type 2 diabetes was not consistent and potentially biased. Our review established a gap in knowledge and suggests that further high-quality studies are needed to examine the association between subthreshold depression and self-care behaviors in people with type 2 diabetes.Systematic review registrationPROSPERO CRD42018116373.

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Physical behaviors and chronotype in people with type 2 diabetes.

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Physical behaviors and chronotype in people with type 2 diabetes.

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