Sitting less linked to lower risk of diabetes

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People who spend time walking or even just standing instead of sitting down may be at lower risk of diabetes, a UK study suggests.

Previous research has linked sedentary time to type 2 diabetes, which is tied to aging and obesity and happens when the body can't properly use insulin to convert blood sugar into energy.

For the current study, researchers asked 435 adults at risk for developing diabetes to wear activity monitors around the clock for one week to see how much time they spent sitting, standing and walking. Then they examined lab tests to see how well their bodies processed sugar and insulin.

Findings from this study "provide further encouraging evidence" that simply substituting standing for sitting throughout the day may improve markers of type 2 diabetes, said study co-author Dr. Joseph Henson, a diabetes researcher at the University of Leicester.

"However, stronger associations were observed for stepping, thus highlighting the continued importance of more intense physical activity," Henson said by email.

Tips on living well with diabetes

  • People with diabetes know that they need to take control of their eating habits because blood sugar levels in the body are directly affected by the foods we eat.
  • A diabetic diet is an eating plan that is high in nutrients and fibre, low in fat, sugar and salt, and moderate in calories
  • The only difference is that you need to pay more attention to your food choices
  • Controlling carbs: If you have diabetes, excessive intake of carbohydrates will lead to high blood sugar levels and poor control of diabetes.
  • Load up on greens: Loading up on vegetables, especially green leafy ones, will assist in blood sugar and weight control, and promote a healthy heart.
  • Choose wisely when eating out: Reduce your food portion size by requesting for less noodles/rice, and avoid dishes with thick gravy or fried foods with flour/bread coating
  • Order more vegetables and have a serving of fruit for dessert.
  • Regular mealtimes: For individuals who are on fixed doses of insulin and/or taking oral medication for diabetes, it is important to maintain regular mealtimes to prevent fluctuation in blood sugar levels and to optimise the effects of the medication.
  • Be active: The reason exercise is so important is because it increases cell sensitivity towards insulin. This means that cells are better able to use any available insulin to take up glucose during and after each physical activity.
  • You can start slowly with a 30-minute brisk walk three times per week and work your way towards a more intensive regime.
  • This helps you to have better blood glucose control and maintain a healthier body weight.
  • If you have diabetic complications such as heart disease, nerve problems or kidney failure, seek the advice of your doctor or an exercise specialist about appropriate exercises to do.
  • Shoes that fit: Comfortable footwear is also important as diabetes causes nerve insensitivity in the feet.
  • Poorly-fitted shoes can lead to foot complications such as ulcers, blisters or corns.
  • Stick to medications: In order to ensure blood sugar targets are achieved, most people with type 2 diabetes will require oral medication and/or insulin, along with living a healthy lifestyle.
  • Keeping clinic appointments: You need to take a proactive role in the management of your healthcare in order to prevent or delay the development of diabetic complications.
  • It is very important to follow the medication dose and timing prescribed by your doctor. It is dangerous to skip medication, or adjust medication dosage and timing without checking with your doctor.
  • Self-monitor blood sugar levels: Regular monitoring of your blood glucose gives you a basic understanding of how your diet, medication and physical activity affects your body and how you can manage it.
  • In general, individuals with diabetes should have comprehensive physical examinations once a year and have their diabetes assessed at least every three to six months.
  • Too little sleep can increase the risk of diabetes, and if you already have diabetes, sleep deprivation can lead to poor blood sugar control.

Study participants were 67 years old on average. Most of them had excess fat around the midsection and were either overweight or obese, and about one third had a family history of diabetes.

Each day, participants spent an average of 9.4 hours sitting or lying down during their waking hours. This included a total of about 4.2 hours of brief periods of sitting for no more than a half hour, as well as 5.4 hours of prolonged bouts of sitting that lasted at least 30 minutes.

In addition, participants typically spent an average of 4.5 hours a day standing and 1.7 hours a day walking.

People who replaced 30 minutes of prolonged sitting time with shorter bouts of sitting had a 4 per cent reduction in fasting insulin levels, researchers calculated.

If participants replaced prolonged sitting with standing, however, they had 5 per cent drop in fasting insulin levels, and walking instead was associated with an 11 per cent difference, researchers report in BMJ Open.

The study didn't find an association between blood sugar or insulin levels when people swapped short periods of sitting for standing, however. Stepping instead of sitting for short periods was linked to a 7 per cent drop in fasting insulin.

The study wasn't a controlled experiment and can't prove how different activity levels directly influence the risk of diabetes, the authors note. Researchers also used statistical models to estimate how much changes in activity might impact blood sugar and insulin.

Still, the results add to a growing body of evidence suggesting that even small reductions in sedentary time may help lower the risk of diabetes, said Bethany Barone Gibbs, a researcher at the University of Pittsburgh who wasn't involved in the study.

"Breaking up prolonged sitting with walking or standing can improve how our body takes up blood glucose," Barone Gibbs said by email.

When the body moves, it signals muscles and cells that will need fuel and they start absorbing sugar from the blood. When people are sedentary, these signals don't go out.

"This is why blood sugar seems to go higher if we engage in prolonged sitting versus more active behaviours after eating," Barone Gibbs added. "If we are constantly exposed to high blood sugar over time, this can cause diabetes and cardiovascular diseases to develop."

Even though the results mirror other studies linking reduced sedentary time to a lower diabetes risk, the use of statistical models rather than a controlled experiment makes it hard to see what would happen if people cut back on sitting in real life, said Peter Katzmarzyk of the Pennington Biomedical Research Center in Baton Rouge, Louisiana.

"The people didn't actually replace their sitting with physical activity, which is what would happen in an intervention," Katzmarzyk, who wasn't involved in the study, added by email. "We need more actual interventions for us to better understand what is going on."

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