Insights on accelerometer-measured 24-hour movement behaviour across type 2 diabetes sub-phenotypes in the Asian population.

Type 2 diabetes participants were classified into three distinct movement behaviour profiles based on 24-hour accelerometer data.

• 706 study participants were included in the analysis.
• Movement behaviour profiles were constructed using time spent in light PA, moderate-vigorous PA, day inactivity, and night sleep per 24-hour period.
• Participants were classified into T2D subgroups (MOD, MARD, SIRD) using age at T2D onset, BMI, HbA1c, homeostasis model assessment 2 estimates of beta-cell function and insulin resistance.
• Three movement behaviour profiles were identified: a least active profile, an intermediate profile, and a most active profile.

Compared to mild obesity-related diabetes (MOD), mild age-related diabetes (MARD) participants had a lower relative risk of being in the least active profile and a higher relative risk of being in the most active profile.

• The relative risk ratio (RRR) of having the least active profile for MARD compared to MOD was 0.69 (95% CI 0.43–1.10).
• The RRR of having the most active profile for MARD compared to MOD was 1.53 (95% CI 0.82–2.83).
• Both confidence intervals crossed 1.0, indicating these associations were not statistically significant.
• MARD is characterized by mild age-related diabetes as a subphenotype.

Compared to mild obesity-related diabetes (MOD), severe insulin-resistant diabetes (SIRD) participants had higher relative risk ratios for both the least active and most active movement behaviour profiles.

• The RRR of having the least active profile for SIRD compared to MOD was 1.32 (95% CI 0.85–2.04).
• The RRR of having the most active profile for SIRD compared to MOD was 1.44 (95% CI 0.76–2.72).
• Both confidence intervals crossed 1.0, indicating these associations were not statistically significant.
• SIRD is characterized by severe insulin resistance as a subphenotype.

Previously identified T2D subgroups (MOD, MARD, SIRD) had distinct characteristics and complication profiles in this Asian population.

• The subgroup classification was based on five variables: age at T2D onset, body mass index, HbA1c, homeostasis model assessment 2 estimates of beta-cell function, and insulin resistance.
• Three subgroups were identified: mild obesity-related diabetes (MOD), mild age-related diabetes (MARD), and severe insulin-resistant diabetes (SIRD).
• The authors note that physical activity reduces the risk of complications, motivating investigation of whether movement behaviour differs by T2D subgroup.
• The study population was drawn from an Asian population context.

The study identified that different T2D subphenotypes may be associated with different movement behaviour profiles, supporting the rationale for targeted physical activity interventions.

• MARD showed a trend toward being more active (lower risk of least active profile, higher risk of most active profile) compared to MOD.
• SIRD showed a trend toward elevated risk in both least and most active profiles compared to MOD, suggesting a more heterogeneous distribution.
• The authors conclude that understanding the relationship between T2D subgroups and movement behaviour is 'a step towards advocating for PA intervention tailored to each subgroup's unique characteristics.'
• No statistically significant associations were detected, as all 95% confidence intervals included the null value of 1.0.