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

Introduction Previously, we observed that subgroups of type 2 diabetes (T2D) – mild obesity-related diabetes (MOD), mild age-related diabetes (MARD), severe insulin-resistant diabetes (SIRD) – had distinct characteristics and complications. This study aims to investigate if movement behaviour also differs by T2D subgroup. Given that physical activity (PA) reduces the risk of complications, identifying less active subgroups could inform more targeted interventions. Methods Using age at T2D onset, body mass index, hbA1c, homeostasis model assessment 2 estimates of beta-cell function and insulin resistance, 706 study participants were classified into T2D subgroups. Using time spent in light PA, moderate-vigorous PA, day inactivity and night sleep per 24-hour, the participants were classified into three profiles. Regression models were used to examine the association between T2D subgroup (exposure) and movement behaviour (outcome). Results Compared to MOD, the relative risk ratio (RRR) of having the least active profile was 0.69 (95%CI 0.43-1.10), while the RRR of having the most active profile was 1.53 (95%CI 0.82-2.83) for MARD. The RRRs of having the least and most active profile was 1.32 (95%CI 0.85-2.04) and 1.44 (95%CI 0.76-2.72) respectively for SIRD. Conclusion Understanding the relationship between T2D subgroups and movement behaviour is a step towards advocating for PA intervention tailored to each subgroup’s unique characteristics.