Association of free-living physical activity measures with metabolic phenotypes in type 2 diabetes at the time of diagnosis. The Verona Newly Diagnosed Type 2 Diabetes Study (VNDS)

Lifestyle is considered a major determinant of risk of type 2 diabetes (T2D). We investigated whether daily physical activity (DPA) is associated with beta-cell function (BF) and/or insulin sensitivity (IS) in patients with T2D at the time of diagnosis. In 41 subjects enrolled in the Verona Newly-Diagnosed Type 2 Diabetes Study we assessed: (1) IS, by euglycaemic insulin clamp; (2) BF, estimated by prolonged-OGTT minimal modeling and expressed as derivative and proportional control; (3) DPA and energy expenditure (EE), assessed over 48-h monitoring by a validated wearable armband system. Study participants (median [IQR]; age: 62 [53–67] years, BMI: 30.8 [26.5–34.3] Kg m−2, HbA1c: 6.7 [6.3–7.3]%; 49.7 [45.4–56.3] mmol/mol) were moderately active (footsteps/day: 7773 [5748–10,927]; DPA≥3MET: 70 [38–125] min/day), but none of them exercised above 6 metabolic equivalents (MET). EE, expressed as EETOT (total daily-EE) and EE≥3MET (EE due to DPA≥3MET) were 2398 [2226–2801] and 364 [238–617] Kcal/day, respectively. IS (M-clamp 630 [371–878] μmol/min/m2) was positively associated with DPA and EE, independent of age, sex and BMI (p