Physical activity, inactivity and sleep during the Diabetes Remission Clinical Trial (DiRECT)

Cassidy, S. et al. (2023) Physical activity, inactivity and sleep during the Diabetes Remission Clinical Trial (DiRECT). Diabetic Medicine, 40(3), e15010. (doi: 10.1111/dme.15010) (PMID:36398460)

Abstract

Aims: As sustained weight loss is vital for achieving remission of type 2 diabetes, we explored whether randomisation to weight loss plus maintenance in the DiRECT trial was associated with physical activity, inactivity or sleep. Methods: Participants were randomised to either a dietary weight management programme or best-practice care. The weight management group were encouraged to increase daily physical activity to their sustainable maximum. Objective measurement was achieved using a wrist-worn GENEActiv accelerometer for 7 days at baseline, 12 and 24 months in both groups. Results: Despite average weight loss of 10 kg at 12 months in the intervention (n = 66) group, there were no differences in total physical activity or inactivity compared with the control (n = 104) at any time point. However, in our exploratory analysis, those who lost more than 10% of their baseline body weight performed on average 11 mins/day more light activity than the <10% group at 24 months (p = 0.033) and had significantly lower bouts of Inactivity30min (interaction, p = 0.005) across 12 and 24 months. At 24 months, the ≥10% group had higher daily acceleration (38.5 ± 12.1 vs. 33.2 ± 11.1 mg, p = 0.020), and higher accelerations in the most active 5-hour period (59.4 ± 21.8 vs. 50.6 ± 18.3 mg, p = 0.023). Wakefulness after sleep onset decreased in the intervention group compared with the control group and also in the ≥10% weight loss group at 12 and 24 months. Conclusions: Randomisation to a successful intensive weight loss intervention, including regular physical activity encouragement, was not associated with increased physical activity although sleep parameters improved. Physical activity was greater, and night-time waking reduced in those who maintained >10% weight loss at 12 and 24 months. Trial Registration: ISRCTN03267836.

• Item Type: Articles
• Additional Information: The work was supported by grant 17/0005616 from Diabetes UK.
• Keywords: Diabetes remission, lifestyle intervention, physical activity, sleep, weight loss maintenance.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: McCombie, Ms Louise and McConnachie, Professor Alex and Brosnahan, Dr Naomi and Lean, Professor Michael and Thom, Dr George and Sattar, Professor Naveed and Leslie, Dr Wilma
• Authors: Cassidy, S., Trenell, M., Stefanetti, R. J., Charman, S. J., Barnes, A. C., Brosnahan, N., McCombie, L., Thom, G., Peters, C., Zhyzhneuskaya, S., Leslie, W. S., Catt, C., Catt, M., McConnachie, A., Sattar, N., Sniehotta, F. F., Lean, M. E.J., and Taylor, R.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Diabetic Medicine
• Publisher: Wiley
• ISSN: 0742-3071
• ISSN (Online): 1464-5491
• Published Online: 18 November 2022
• Copyright Holders: Copyright © 2022 The Authors
• First Published: First published in Diabetic Medicine 40(3): e15010
• Publisher Policy: Reproduced under a Creative Commons License