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Insulin-Associated Weight Gain in Type 2 Diabetes Is Associated With Increases in Sedentary Behavior

The insulin therapy–mediated weight gain in patients with type 2 diabetes (T2D) may relate to altered physical activity patterns (1). In this study, we examined the hypothesis that initiation of insulin therapy would be associated with an increase in sedentary behavior (i.e., sitting time) and lower low-, moderate-, and vigorous-intensity physical activity, which would subsequently relate to weight gain.

We included 40 T2D patients who started insulin therapy and followed these patients for a period of 12 months. Patients were randomly selected from one university hospital, three nonuniversity teaching hospitals, and four primary care practices. The decision to start insulin treatment was at the discretion of the responsible physician and was always based on failure of glycemic control while on oral glucose-lowering agents and diet. Measurements were performed before and 6 months and 12 months after initiation of insulin therapy. We examined body weight, waist-to-hip circumference, fasting glucose, and HbA1c using standardized procedures. Free-living daytime physical activity was objectively measured (SenseWear Pro3 Armband, BodyMedia, Pittsburgh, PA) (2). We examined 1 ) time (hours/day) spent in sitting ( 3.0 METs); 2 ) steps per day; and 3 ) sit-to-stand maneuvers (transition from …