Comparison of Physical Function and Physical Activity between Above and Below Recommended Glucose Target Range in Older People with Type 2 Diabetes

Tali Cukierman–Yaffe ^1,2,7 Tal Yahalom ^1,2 Einat Kodesh ³ Yamit Basson-Shleymovich ^1,2,4 Michal Azmon ^1,5 Veronica Bogina ⁶ Tsvi Kuflik ⁶

¹Division of Endocrinology, Diabetes and Metabolism Center for Successful Aging with diabetes, Sheba Medical Center
²Epidemiology Department, Sackler School of Medicine, Tel-Aviv University
³Physical Therapy Department, Faculty of Social Welfare and Health Sciences, University of Haifa
⁴Bnei-Brak physical Therapy Clinic, Clalit Health Services
⁵Faculty of Health Sciences, Ariel University
⁶Information Systems Department, The Faculty of Social Sciences, the University of Haifa
⁷Herczeg Institute on Aging, Tel-Aviv University

Introduction:
Physical activity (PA) is reported to be important for blood glucose management and overall health. Individuals with diabetes are encouraged to engage in exercise and to increase their total daily PA. Continuous glucose monitoring (CGM) identifies an individual’s current glycemic status and provides valuable information about the amount of time spent in the recommended glucose target range (70-180 mg/dL), defined as Time in Range% (TIR). In this study we aimed to compare the physical function (PF) and PA between individuals with a lower and higher TIR.

Methods:
Twenty participants were recruited at "The Center for Successful Aging with Diabetes", Sheba Medical Center. They underwent PF tests including the 6-minute walk test (6MW) to asses aerobic capacity and the Sit-to-Stand test (STS) to asses leg strength. They were connected to a CGM system (I Pro2 carelink, Medtronic) and wore an activity device (ActiGraph GT9X) for a week. Number of steps, sedentary and light to vigorous activity time were recorded. Individuals were divided into 2 groups according to the TIR% obtained from the CGM (>70% and ≤70%), all outcome measurements were compared between the groups.

Results:
The >70%TIR group demonstrated significant (p=0.04) higher performance on the STS test and trend towards statistical significance (p=0.07) on the 6MW. No significant differences were found between the groups in the number of steps, and time in sedentary, light to vigorous activity.

Discussion:
Participants with higher %TIR performed better in functional tests, however their daily PA was no different from the group with lower %TIR.