BACKGROUND Excessive daily sitting time (of which 60% is accrued at the workplace) is an independent risk factor for cardiovascular disease and type 2 diabetes. While our laboratory has demonstrated that breaking up prolonged sitting has beneficial metabolic outcomes in people with type 2 diabetes, the longer-term benefits and cost-effectiveness of intervening to reduce sitting have never been tested in this high-risk group. THE PROJECT Office-based workers aged 45-65 years with type 2 diabetes (n=250) will be randomly assigned to an intervention or a control (usual-care) group. The 6-month multicomponent intervention will include the following: • In-person and telephone behavioural coaching delivered by an accredited allied health professional; • Provision of a sit-to-stand workstation; and, • Smartphone-based self-monitoring and behavioural prompting. The following outcomes will be compared at 3 and 6 months: • Overall sitting time and glycaemic control (HbA1c) (primary). • Sitting time accumulated in prolonged bouts, body composition, cardio-metabolic risk biomarkers and vascular function (secondary). IMPORTANCE Findings from this real-world trial will provide evidence regarding the cost effectiveness, feasibility, and acceptability of these pragmatic approaches to reducing and breaking up sitting time in adults with type 2 diabetes. The findings will also directly inform clinical and broader health system approaches to diabetes management. If successful, the intervention will be a valuable new element of Australia's strategies for the management of major non-communicable diseases. Cavalot F, Petrelli A, Traversa M, et al. Postprandial blood glucose is a stronger predictor of cardiovascular events than fasting blood glucose in type 2 diabetes mellitus, particularly in women: lessons from the San Luigi Gonzaga Diabetes Study. J Clin Endocrinol Metab. 2006;91(3):813-9. Healy GN, Winkler EA, Owen N, Anuradha S, Dunstan DW. Replacing sitting time with standing or stepping: associations with cardio-metabolic risk biomarkers. Eur Heart J. 2015;36(39):2643-9 Healy G, Eakin E, Owen N, Lamontagne A, Moodie M, Winkler EA, et al. A Cluster Randomized Controlled Trial to Reduce Office Workers’ Sitting Time. Med Sci Sports Exerc. 2016(9):1787-97. Pandey A, Salahuddin U, Garg S, et al. Continuous dose-response association between sedentary time and risk for cardiovascular disease: A meta-analysis. JAMA cardiology. 2016;1(5):575-83. Dunstan D, Kingwell B, Larsen R, Healy G, Cerin E, Hamilton M, et al. Breaking up prolonged sitting reduces postprandial glucose and insulin responses. Diabetes Care. 2012;35(5):976-83. Dempsey PC, Larsen RN, Sethi P, Sacre JW, Straznicky NE, Cohen ND, Cerin E, Lambert GW, Owen N, Kingwell BA, Dunstan DW. Benefits for type 2 diabetes of interrupting prolonged sitting with brief bouts of light walking or simple resistance activities. Diabetes Care. 2016;39(6):964-72.
Sedentary behaviour, Sitting time, Physical Activity, Type 2 Diabetes, Workplace, Population Health
Top-up scholarship funding available