Work

Analysing physical activity measures and clustering in patients with type 2 diabetes in secondary care: insights from the DIAbetes and LifEstyle Cohort Twente (DIALECT)—an observational cohort study

Year: 2024

Type: article

Abstract: Objectives To analyse variance in accelerometer-based physical activity (PA) measures in patients with type 2 diabetes, identify the most distinctive PA measures and classify patients into different PA clusters based on these measures. Design DIAbetes and LifEstyle Cohort Twente (DIALECT), an observational cohort study. Setting Secondary care in the Netherlands. Participant 253 patients, with three excluded due to insufficient data. The cohort was predominantly male (66%) with an average age of 64.7 years. Primary and secondary outcome measures The primary outcomes of DIALECT were all-cause mortality, microvascular and macrovascular diseases. The secondary outcomes are blood pressure levels, kidney function indicators and albuminuria levels Results Principal component analysis (PCA) was applied to 53 accelerometer-derived PA measures. Principal components were identified using a scree plot, key measures determining the principal components were derived and k-mean cluster analysis was applied to the components. The main PA measures were steps/day, active time, zero steps, total sedentary behaviour (SB) bout duration and total moderate to vigorous physical activity (MVPA) bout duration. Based on three PCA components, three clusters were identified. The inactive cluster had a higher BMI, diabetes duration, age and SB bout duration, and lower steps/day and MVPA bout duration compared with the other clusters (p<0.05). The active cluster still scores low on MVPA bout duration (18 min/week) and high on SB bout duration (5.0 hours/day). Conclusions PA behaviour in patients can be categorised into three distinct clusters. The identified PA measures and behaviour clusters offer promising opportunities for tailored lifestyle treatment. However, further studies are needed to determine which PA measures are clinically most relevant, validate the usefulness of this classification and evaluate whether tailoring lifestyle advice according to these clusters adds clinical value. Trial registration number NTR5855.

Source: BMJ Open

DOI: 10.1136/bmjopen-2023-082059

Authors: Niala den Braber, Miriam M Vollenbroek-Hutten, Kilian D R Kappert, Gozewijn D Laverman

Institutions: Ziekenhuis Groep Twente, University of Twente

Language: English

Topic: Physical Activity and Health

Subfield: Physiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,839