Insulin Therapy Initiation in T2D Associated With Sedentary Behavior, Weight Increases

Which factors increase the risk of gestational diabetes?
Which factors increase the risk of gestational diabetes?
Patients with type 2 diabetes who were initiated on insulin therapy increased their sitting time and decreased their low-intensity physical activity.

Initiation of insulin therapy in patients with type 2 diabetes (T2D) was associated with an increase in sedentary behavior, according to a study published in Diabetes Care.

Researchers from The Netherlands and United Kingdom examined body weight, waist-to-hip circumference, fasting glucose, and hemoglobin A1c (HbA1c) in 40 patients with T2D who were recently initiated on insulin therapy. Measurements were taken before as well as 6 and 12 months after insulin therapy began.

During the course of 12 months, researchers found patients’ body weight increased 2.9±4.5 kg (P <.05), but fasting glucose and HbA1c values decreased (both P <.05). In addition, patients’ sitting time increased and low-intensity physical activity (defined as 2.1-3.0 METs) decreased. Meanwhile, moderate-to-vigorous levels of physical activity decreased, including number of steps (7854±3936 to 6060±3022) and sit-to-stand maneuvers (20±5 to 18±6; both P <.05).

Patients with a body mass index (BMI) <30 kg/m2 demonstrated shorter sitting times (age 64 years; P =.012) and longer periods of low-intensity physical activity (P =.012) compared with patients with BMI ≥30 kg/m2 (age 57 years). BMI and waist circumference increased in patients with BMIs <30 kg/m2 but not in patients with BMIs ≥30 kg/m2.

Sitting times increased while energy expenditure decreased in patients with lower BMIs vs patients with higher BMIs. The researchers determined there was a positive relationship between changes in weight and waist circumference changes vs sitting time.

“This suggests that increased sedentary behavior, especially in nonobese T2D patients, may contribute to body weight gain after initiation of insulin therapy,” the researchers concluded. “[S]edentary behavior assessment and intervention may be needed in T2D management.”

Related Articles


Hartman YAW, Jansen HJ, Hopman MTE, Tack CJ, Thijssen DHJ. Insulin-associated weight gain in type 2 diabetes is associated with increases in sedentary behavior [published online July 10, 2017]. Diabetes Care. doi:10.2337/dc17-0787