title: Adding exercise or subtracting sitting time for glycaemic control: where do we stand?
abstract: While regular structured exercise is a well-established (though arguably under-utilised) cornerstone in the prevention and management of type 2 diabetes, population adherence to recommended exercise guidelines remains stubbornly low. Indeed, most adults are exposed to environmental settings (at work, in automobile travel and in the domestic environment) that may not only limit their physical activity, but also promote sitting for prolonged periods of time. However, recent experimental evidence indicates that reducing and breaking up sitting time may also be a useful strategy to improve glycaemic control. In this issue of Diabetologia, Duvivier and colleagues report findings which suggest that reducing sitting time with standing and light-intensity activity could be a potential alternative to structured exercise for improving glycaemic control in type 2 diabetes patients. We review and discuss the findings of this study, its potential clinical implications, and a number of knowledge gaps and opportunities that could be considered in the interest of future research. The findings from Duvivier and colleagues should encourage healthcare practitioners, researchers and type 2 diabetes patients to consider the whole spectrum of physical activity, from sedentary behaviour through to structured exercise.
authors.affiliation: Baker IDI Heart and Diabetes Institute, Level 4, 99 Commercial Rd, Melbourne, VIC, 3004, Australia. paddy.dempsey@bakeridi.edu.au.|Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia. paddy.dempsey@bakeridi.edu.au.
authors.forename: Paddy C
authors.initials: PC
authors.lastname: Dempsey
authors.affiliation: Baker IDI Heart and Diabetes Institute, Level 4, 99 Commercial Rd, Melbourne, VIC, 3004, Australia.|Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia.|School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, Australia.
authors.forename: Megan S
authors.initials: MS
authors.lastname: Grace
authors.affiliation: Baker IDI Heart and Diabetes Institute, Level 4, 99 Commercial Rd, Melbourne, VIC, 3004, Australia.|Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia.|Institute of Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, Australia.|School of Sport Science, Exercise and Health, The University of Western Australia, Perth, WA, Australia.|Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia.
authors.forename: David W
authors.initials: DW
authors.lastname: Dunstan
mesh_terms: D001786:Blood Glucose / Q000502:physiology; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control / Q000628:therapy*; D004734:Energy Metabolism / Q000502:physiology; D015444:Exercise / Q000502:physiology*; D006801:Humans; D057185:Sedentary Behavior
chemical_list: D001786:Blood Glucose
keywords: Cardiometabolic; Cardiovascular; Continuous glucose monitor; Diabetes; Energy expenditure; Exercise; Glycaemic control; Lipids; Objective; Patterns; Physical activity; Public health; Sedentary; Sitting