Differential impact of lifestyle factors on 2-hour glucose values in individuals with type 2 diabetes: potential for more personalized interventions
Introduction Lifestyle determinants of 2-hour glucose concentration in people with type 2 diabetes and interindividual differences need to be identified.Research design and methods 38 participants with type 2 diabetes, treated with lifestyle advice and/or metformin, tracked their physical activity,...
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| Language: | English |
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BMJ Publishing Group
2024-12-01
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| Series: | BMJ Open Diabetes Research & Care |
| Online Access: | https://drc.bmj.com/content/12/6/e004506.full |
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| author | Hanno Pijl Tim Snel Tanja Krone Regina J M Kamstra Hannah M Eggink Albert A de Graaf Iris M de Hoogh |
| author_facet | Hanno Pijl Tim Snel Tanja Krone Regina J M Kamstra Hannah M Eggink Albert A de Graaf Iris M de Hoogh |
| author_sort | Hanno Pijl |
| collection | DOAJ |
| description | Introduction Lifestyle determinants of 2-hour glucose concentration in people with type 2 diabetes and interindividual differences need to be identified.Research design and methods 38 participants with type 2 diabetes, treated with lifestyle advice and/or metformin, tracked their physical activity, sleep and dietary intake, while continuously monitoring interstitial glucose concentrations for 11 periods of four consecutive days each. A linear mixed-effects model was used to quantify the effect of sleep, stress, current glucose, carbohydrate intake and exercise on glucose levels 2 hours later.Results The final model identified carbohydrate intake (grams) in the past 5 min as well as in the past 30 min, sleep duration during the previous night (hours) and physical activity (metabolic equivalents) over the past 12 hours as significant fixed effects that influenced glucose concentrations 2 hours later. In addition, carbohydrate intake in the past 5 and past 30 min, and physical activity in the past and future 30 min were included as random or individualized effects. Although carbohydrate intake led to increased glucose concentrations in 2 hours in all individuals, the magnitude of this effect varied between individuals. The physical activity on glucose concentrations in 2 hours varied among individuals as well, in terms of magnitude and in terms of direction (showing either increase or decline).Conclusions Carbohydrate intake, sleep and physical activity at specific points in time have both fixed as well as individualized effects on glucose concentrations 2 hours later in individuals with type 2 diabetes. Interindividual differences in glycemic response to lifestyle components call for personalized advice in the management of type 2 diabetes. |
| format | Article |
| id | doaj-art-b8e3b36a99b343b79479298ce8e1f9c2 |
| institution | Kabale University |
| issn | 2052-4897 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open Diabetes Research & Care |
| spelling | doaj-art-b8e3b36a99b343b79479298ce8e1f9c22025-01-06T17:25:08ZengBMJ Publishing GroupBMJ Open Diabetes Research & Care2052-48972024-12-0112610.1136/bmjdrc-2024-004506Differential impact of lifestyle factors on 2-hour glucose values in individuals with type 2 diabetes: potential for more personalized interventionsHanno Pijl0Tim Snel1Tanja Krone2Regina J M Kamstra3Hannah M Eggink4Albert A de Graaf5Iris M de Hoogh62 Division of Internal Medicine, Leids Universitair Medisch Centrum, Leiden, The NetherlandsMedical Affairs, Roche Diagnostics, Almere, NetherlandsRisk Analysis for Prevention, Innovation & Development, Netherlands Organization for Applied Scientific Research, Utrecht, NetherlandsMicrobiology & Systems Biology, Netherlands Organization for Applied Scientific Research, Zeist, NetherlandsMicrobiology & Systems Biology, Netherlands Organization for Applied Scientific Research, Zeist, NetherlandsRisk Analysis for Prevention, Innovation & Development, Netherlands Organization for Applied Scientific Research, Utrecht, NetherlandsEndocrinology, Leiden Universitair Medisch Centrum, Leiden, NetherlandsIntroduction Lifestyle determinants of 2-hour glucose concentration in people with type 2 diabetes and interindividual differences need to be identified.Research design and methods 38 participants with type 2 diabetes, treated with lifestyle advice and/or metformin, tracked their physical activity, sleep and dietary intake, while continuously monitoring interstitial glucose concentrations for 11 periods of four consecutive days each. A linear mixed-effects model was used to quantify the effect of sleep, stress, current glucose, carbohydrate intake and exercise on glucose levels 2 hours later.Results The final model identified carbohydrate intake (grams) in the past 5 min as well as in the past 30 min, sleep duration during the previous night (hours) and physical activity (metabolic equivalents) over the past 12 hours as significant fixed effects that influenced glucose concentrations 2 hours later. In addition, carbohydrate intake in the past 5 and past 30 min, and physical activity in the past and future 30 min were included as random or individualized effects. Although carbohydrate intake led to increased glucose concentrations in 2 hours in all individuals, the magnitude of this effect varied between individuals. The physical activity on glucose concentrations in 2 hours varied among individuals as well, in terms of magnitude and in terms of direction (showing either increase or decline).Conclusions Carbohydrate intake, sleep and physical activity at specific points in time have both fixed as well as individualized effects on glucose concentrations 2 hours later in individuals with type 2 diabetes. Interindividual differences in glycemic response to lifestyle components call for personalized advice in the management of type 2 diabetes.https://drc.bmj.com/content/12/6/e004506.full |
| spellingShingle | Hanno Pijl Tim Snel Tanja Krone Regina J M Kamstra Hannah M Eggink Albert A de Graaf Iris M de Hoogh Differential impact of lifestyle factors on 2-hour glucose values in individuals with type 2 diabetes: potential for more personalized interventions BMJ Open Diabetes Research & Care |
| title | Differential impact of lifestyle factors on 2-hour glucose values in individuals with type 2 diabetes: potential for more personalized interventions |
| title_full | Differential impact of lifestyle factors on 2-hour glucose values in individuals with type 2 diabetes: potential for more personalized interventions |
| title_fullStr | Differential impact of lifestyle factors on 2-hour glucose values in individuals with type 2 diabetes: potential for more personalized interventions |
| title_full_unstemmed | Differential impact of lifestyle factors on 2-hour glucose values in individuals with type 2 diabetes: potential for more personalized interventions |
| title_short | Differential impact of lifestyle factors on 2-hour glucose values in individuals with type 2 diabetes: potential for more personalized interventions |
| title_sort | differential impact of lifestyle factors on 2 hour glucose values in individuals with type 2 diabetes potential for more personalized interventions |
| url | https://drc.bmj.com/content/12/6/e004506.full |
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