SIT LESS 2: Effect of Sitting Less on Glucose Regulation in People With Diabetes Mellitus Type 2

NCT ID: NCT02371239

Last Updated: 2016-03-16

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

19 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-02-28

Study Completion Date

2015-05-31

Brief Summary

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Introduction: Changes in lifestyle are responsible for an important part of the type 2 diabetes epidemic of the last decennia. Current guidelines for physical activity focus mainly on high energy expenditure advising 30 minutes per day moderate to vigorous physical activity (most often physical exercise). Recent studies suggest that sitting has negative metabolic effects independent of the time spent exercising (Duvivier et al. PLOS ONE 2013).

Low intensity physical activity (LIPA) -such as walking and standing- has been suggested to be an alternative to decrease the hyperglycaemic effect of sitting. Compared to exercise, LIPA might be a more feasible strategy. But, it remains to be determined whether reducing sitting time by replacing it by LIPA, results in lower 24 hour blood glucose levels and less blood glucose fluctuations (glycaemic variability) in type 2 diabetes patients and whether these effects are independent of the increase in energy expenditure

Methods: The study population will involve 19 people with type 2 diabetes (BMI: 25-35 kg/m2) who perform no, or only little, exercise and who are treated with diet only or with oral blood glucose lowering medication. They will perform three regimes of each four days: 1) a sitting regime, 2) an exercise regime and a 3) sit less regime. Daily energy expenditure of the exercise regime will be identical to that of the sit less regime. Sitting, walking and standing will be objectively measured by a 24 hour physical activity monitor. The energy spent during exercise will be standardised and quantified by using a bicycle ergometer; energy intake will be standardised as well. During each regime blood glucose will be measured with a 24 hour continuous glucose sensor.

Detailed Description

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Conditions

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Type 2 Diabetes

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Sitting regime

The subjects will follow the sitting regime during four days. Each day: 14 hours sitting, 1 hour walking and 1 hour standing for daily care and 8 hours sleeping or lying.

Group Type EXPERIMENTAL

Physical activity intervention

Intervention Type BEHAVIORAL

Sit Less regime

Subjects will follow the sit less regime during four days. Each day will consist of 3 hours walking, 4 hours standing, 9 hours sitting and 8 hours sleeping or lying. The additional 2 hours of walking and 3 hours of standing, compared to the sitting regime, will be done in a minimum of four bouts with a time interval of \> 1 hour. The subjects will be instructed to walk on a slow pace. i.e. 2-3 km/h, which is comparable to walking during shopping, walking to the office etc.

Group Type EXPERIMENTAL

Physical activity intervention

Intervention Type BEHAVIORAL

Exercise regime

Subjects will follow the exercise regime during four days. Each day will consist of 13 hours and 15 minutes sitting, ± 45 minutes supervised cycling on an ergometer, 1 hour walking and 1 hour standing for daily care and 8 hours sleeping or lying.

Group Type EXPERIMENTAL

Physical activity intervention

Intervention Type BEHAVIORAL

Interventions

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Physical activity intervention

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Signed informed consent
* Men and women: 40-75 years old
* Diabetes mellitus type 2, developed after the age of 40 years old
* Treatment with diet or oral blood glucose lowering medication (metformin and/or SU-derivatives and/or DPP-IV inhibitors)
* HbA1c: \< 10%
* BMI: 25.0 - 35.0 kg/m2
* Maximum 2.5 hours of MVPA per week (during last 3 months)
* Internet availability on a daily basis

Exclusion Criteria

* Pregnancy or intention of becoming pregnant
* Alcohol use: \> 2 units per day (during the last 3 months)
* Experimental drug use (during the last 3 months)
* Use of insulin, corticosteroids, vitamin K antagonists and immunosuppressive drugs in the last 3 months
* Triglyceride level \> 10.0 mmol/L
* Fasting plasma glucose level \> 10 mmol/L
* Heart failure NYHA 3 or higher
* Angina pectoris or signs of cardiac ischemia during exercise testing
* COPD Gold 3 or higher
* Glomerular filtration rate (GFR) \< 30 ml/min
* Diagnosis of active cancer (not cancer in the past that is cured)
* Diabetes mellitus type 1
* Intermittent claudication with a walking distance \< 500 meter
* Not able to cycle for ± 45 minutes, as judged from the incremental exhaustive exercise bicycle-ergometer test at Visit 1
* Based on historical information not able to walk for 3 hours per day and stand for 4 hours per day
* Mental or physical disability which makes physical activity not possible
* Participation in a clinical trial with medication use (in the last 3 months)
* Severe loss of vision
* Active foot ulcer or venous leg ulcer
Minimum Eligible Age

40 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Novo Nordisk A/S

INDUSTRY

Sponsor Role collaborator

Maastricht University Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Nicolaas C Schaper, MD PhD

Role: PRINCIPAL_INVESTIGATOR

Maastricht University Hospital

Locations

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Human Movement Science, Maastricht University

Maastricht, Limburg, Netherlands

Site Status

Countries

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Netherlands

References

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Duvivier BM, Schaper NC, Bremers MA, van Crombrugge G, Menheere PP, Kars M, Savelberg HH. Minimal intensity physical activity (standing and walking) of longer duration improves insulin action and plasma lipids more than shorter periods of moderate to vigorous exercise (cycling) in sedentary subjects when energy expenditure is comparable. PLoS One. 2013;8(2):e55542. doi: 10.1371/journal.pone.0055542. Epub 2013 Feb 13.

Reference Type BACKGROUND
PMID: 23418444 (View on PubMed)

Duvivier BM, Schaper NC, Hesselink MK, van Kan L, Stienen N, Winkens B, Koster A, Savelberg HH. Breaking sitting with light activities vs structured exercise: a randomised crossover study demonstrating benefits for glycaemic control and insulin sensitivity in type 2 diabetes. Diabetologia. 2017 Mar;60(3):490-498. doi: 10.1007/s00125-016-4161-7. Epub 2016 Nov 30.

Reference Type DERIVED
PMID: 27904925 (View on PubMed)

Related Links

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Other Identifiers

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NL45498.068.13

Identifier Type: REGISTRY

Identifier Source: secondary_id

13-2-050

Identifier Type: -

Identifier Source: org_study_id

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