In the Italian Diabetes and Exercise Study_2 (IDES_2), behavioral counseling promoted a sustained increase in physical activity (PA) volume (+3.3 MET h ⋅ week^–1), moderate- to vigorous-intensity PA (MVPA) (+6.4 min ⋅ day^–1), and light-intensity PA (LPA) (+0.8 h ⋅ day^–1) and decrease in sedentary time (SED-time) (–0.8 h ⋅ day^–1). Here, we investigated the relationships of changes in PA/SED-time with changes in physical fitness and cardiometabolic risk profile in individuals with type 2 diabetes.

In this 3-year randomized clinical trial, 300 physically inactive and sedentary patients were randomized 1:1 to receive 1-month theoretical and practical counseling once a year or standard care. Changes in physical fitness and cardiovascular risk factors/scores according to quartiles of accelerometer-measured changes in PA/SED-time were assessed, together with univariate and multivariable associations between these parameters, in the whole cohort and by study arm.

Physical fitness increased and HbA_1c and coronary heart disease 10-year risk scores decreased with quartiles of MVPA and SED-time change. In quartile IV of MVPA increase and SED-time decrease, cardiorespiratory fitness increased by 5.23 and 4.49 mL ⋅ min^–1 ⋅ kg^–1 and HbA_1c decreased by 0.73 and 0.85%, respectively. Univariate correlations confirmed these relationships, and mean changes in both MPVA and SED-time predicted changes in physical fitness and cardiovascular risk factors/scores independently of one another and of other confounders. Similar findings were observed with LPA and PA volume and in each group separately.

Even modest increments in MVPA may have a clinically meaningful impact, and reallocating SED-time to LPA may also contribute to improved outcomes, possibly by increasing total energy expenditure.

在意大利糖尿病和运动研究_2 (IDES_2) 中，行为咨询促进了身体活动 (PA) 量的持续增加（+3.3 MET h ⋅ week ^–1），中等到高强度 PA (MVPA)（+6.4 min ⋅第^–1天）和光强度 PA (LPA)（+0.8 小时 ⋅ 第^–1天）和减少久坐时间（SED 时间）（–0.8 小时 ⋅ 第^–1天）。在这里，我们研究了 2 型糖尿病患者 PA/SED 时间变化与身体健康和心脏代谢风险状况变化之间的关系。

在这项为期 3 年的随机临床试验中，300 名缺乏运动和久坐的患者按 1:1 的比例随机接受每年一次为期 1 个月的理论和实践咨询或标准护理。根据加速度计测量的 PA/SED 时间变化的四分位数，在整个队列和研究组中评估了身体健康和心血管危险因素/分数的变化，以及这些参数之间的单变量和多变量关联。

随着 MVPA 和 SED 时间的四分位数变化，身体健康增加，HbA _1c和冠心病 10 年风险评分降低。在 MVPA 增加和 SED 时间减少的四分位数 IV 中，心肺健康分别增加了 5.23 和 4.49 mL·min ^–1 ·kg ^–1，HbA _1c分别减少了 0.73 和 0.85%。单变量相关性证实了这些关系，并且 MPVA 和 SED 时间的平均变化预测了身体健康和心血管危险因素/评分的变化，彼此独立且与其他混杂因素无关。在 LPA 和 PA 体积以及每组中分别观察到类似的发现。

即使 MVPA 的适度增加也可能具有临床上有意义的影响，并且将 SED 时间重新分配给 LPA 也可能有助于改善结果，可能是通过增加总能量消耗。