Age at diagnosis of type 2 diabetes and accelerometer-assessed 24-h physical behaviours: a cross-sectional pooled analysis

Abstract Aims/hypothesis We investigated the association between age at diagnosis of type 2 diabetes and accelerometer-assessed 24-h physical behaviours. Methods This cross-sectional study pooled data from three studies involving participants with and without type 2 diabetes. Physical activity (moderate-to-vigorous physical activity [MVPA], likelihood of meeting physical activity guidelines, step count and total physical activity), sedentary behaviour and sleep (sleep window, actual sleep duration and wakefulness after sleep onset) were measured with wrist-worn accelerometery. Generalised linear models were used to estimate 24-h physical behaviours in individuals with and without newly diagnosed type 2 diabetes across age. Accounting for age-related variations among those without type 2 diabetes enabled interpretation of whether physical behaviours truly differed from those expected for a given age. A sensitivity analysis was performed with additional adjustment for BMI. Results We included 1139 individuals with type 2 diabetes and 660 individuals without diabetes. Earlier age at diagnosis of type 2 diabetes was associated with progressively lower levels of physical activity compared with individuals without type 2 diabetes; for example, at age 20 years, individuals with newly diagnosed type 2 diabetes undertook less than half the MVPA (− 33 [95% CI − 55, − 11] min/day) and daily steps (− 4771 [− 7740, − 1802] steps/day) as individuals without diabetes. In comparison with individuals without type 2 diabetes, earlier diagnosis was associated with more adverse sedentary behaviour and a shorter sleep window. Differences in other sleep behaviours between individuals with type 2 diabetes and those without did not vary with age. Patterns remained mostly unchanged after further adjustment for BMI, although differences in physical activity outcomes between those with and without type 2 diabetes were generally smaller. Conclusions/interpretation Younger age at type 2 diabetes diagnosis is associated with a progressively more adverse profile of physical activity and sedentary behaviour compared with individuals without diabetes. Further research is warranted to determine the effectiveness of lifestyle interventions in the prevention and management of type 2 diabetes in younger adults.