It is well-known that physical activity plays a crucial role in managing diabetes, particularly type 2 diabetes. However, recent research suggests that even individuals with type 1 diabetes (T1D) can benefit from interrupting prolonged sitting with frequent short bouts of light-intensity activity. A new study called the SIT-LESS randomized controlled trial investigated the effects of this approach on glycaemic control in people with T1D. The findings of this trial, conducted in 2023, shed light on the importance of incorporating light-intensity activity into the daily routine of individuals with T1D.

What is the SIT-LESS Randomized Controlled Trial?

The SIT-LESS trial was designed to examine the impact of interrupting prolonged sitting with frequent short bouts of light-intensity activity on glycaemic control in individuals with T1D. The study involved 32 inactive adults with T1D, aged around 27.9 years, with a diabetes duration of about 16.0 years. The participants underwent two 7-hour experimental conditions in a randomized crossover fashion, with a washout period of more than 7 days between each condition.

During the experimental conditions, the participants either engaged in uninterrupted sitting (SIT) or interrupted sitting with 3-minute bouts of self-paced walking at 30-minute intervals (SIT-LESS). Standardized mixed-macronutrient meals were given at 3.5-hour intervals during each condition. Continuous glucose monitoring was used to measure interstitial glucose responses during the 7-hour experimental period and for an additional 48 hours under free-living conditions.

How Does Interrupting Prolonged Sitting Impact Glycaemic Control in People with Type 1 Diabetes?

The results of the SIT-LESS trial clearly demonstrate the positive effects of interrupting prolonged sitting on glycaemic control in individuals with T1D. Here are key findings from the study:

  • SIT-LESS reduced the total mean glucose levels compared to uninterrupted sitting. The mean glucose level decreased from 8.2 mmol/L during uninterrupted sitting to 6.9 mmol/L during interrupted sitting, which is a significant 1.3 mmol/L reduction.
  • SIT-LESS increased the amount of time spent in the target glucose range of 3.9-10.0 mmol/L by 13.7%. Participants spent 71.5% of the time in range during uninterrupted sitting, which increased to 85.1% during interrupted sitting.
  • Hyperglycaemia, defined as glucose levels exceeding 10.0 mmol/L, was reduced by 15.0% under the interrupted sitting condition compared to uninterrupted sitting.
  • Interestingly, there was no significant difference in hypoglycaemia exposure (glucose levels below 3.9 mmol/L) between the two conditions.
  • Interrupting prolonged sitting also led to a 7.8% reduction in glycaemic variability, as measured by the coefficient of variation.

Overall, the findings of the SIT-LESS trial indicate that breaking up prolonged sitting with frequent short bouts of light-intensity activity can improve acute postprandial and 48-hour glycaemia in adults with T1D. This pragmatic strategy offers an effective approach to reduce sedentary behavior and increase physical activity levels without increasing the risk of hypoglycaemia.

Does Increasing Light-Intensity Activity Reduce Hypoglycemia Risk in Individuals with Type 1 Diabetes?

One of the noteworthy findings from the SIT-LESS trial is that increasing light-intensity activity did not increase the risk of hypoglycaemia in individuals with T1D. Hypoglycaemia, characterized by low blood glucose levels, is a significant concern for people with T1D, as it can lead to serious complications if not properly managed.

The results of the trial showed that hypoglycaemia exposure, defined as glucose levels below 3.9 mmol/L, was comparable between the uninterrupted sitting and interrupted sitting conditions. This suggests that incorporating short bouts of light-intensity activity into the daily routine does not pose an increased risk of hypoglycaemia in individuals with T1D.

This finding is particularly encouraging, as it highlights the potential for individuals with T1D to engage in light-intensity activities, such as short walks, without worrying about adverse effects on their blood glucose levels. By finding ways to interrupt prolonged sitting and incorporate more light-intensity activity into their daily lives, people with T1D can take a proactive step towards improved glycaemic control without compromising their safety.

Real-World Implications

The findings of the SIT-LESS trial have significant implications for individuals with T1D and healthcare professionals involved in diabetes management. One practical implication is that incorporating short bouts of light-intensity activity throughout the day can be an effective strategy to improve glycaemic control in individuals with T1D. This can be as simple as taking short walks or performing light exercises every 30 minutes.

By interrupting prolonged sitting, individuals with T1D can reduce their mean glucose levels, spend more time within the target glucose range, and decrease the risk of hyperglycaemia. Additionally, the 7.8% reduction in glycaemic variability observed in the study suggests that interrupting sitting also contributes to more stable blood glucose levels.

Healthcare professionals should consider educating their patients with T1D about the benefits of interrupting prolonged sitting and incorporating light-intensity activities into their daily routines. This approach not only improves glycaemic control but also addresses the negative consequences of a sedentary lifestyle, which can include obesity, cardiovascular issues, and reduced overall fitness.

To support behaviour change, healthcare providers can provide specific recommendations on the duration and intensity of light-intensity activity breaks throughout the day. They can also emphasize the importance of individualizing exercise recommendations to fit each person’s capabilities and preferences.

It is important to note that the SIT-LESS trial focused specifically on individuals with T1D, and further research is needed to explore the benefits of interrupting prolonged sitting in individuals with type 2 diabetes or other forms of diabetes. However, the findings of this study provide a strong foundation for future research in these areas.

Takeaways

The SIT-LESS trial demonstrates that interrupting prolonged sitting with frequent short bouts of light-intensity activity significantly improves glycaemic control in adults with T1D. This approach reduces mean glucose levels, increases time spent within the target glucose range, and decreases hyperglycaemia risk without increasing the risk of hypoglycaemia.

These findings have important implications for individuals with T1D who are looking for practical strategies to manage their diabetes more effectively. Incorporating light-intensity activity breaks throughout the day can be a simple but highly effective way to improve overall glycaemic control and reduce the negative health consequences associated with sedentary behavior.

Source: SIT-LESS randomised controlled trial

Disclaimer: While I have a passion for health, I am not a medical doctor and this is not medical advice.

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