(P08-022-23) Association of Physical Activity and Sleep Quality With Glycemic Variability and Glycemic Control in Indian Adults With Type 2 Diabetes: A Case Series Study

Objectives: High glycemic variability increases the risk of short and long-term complications in people with diabetes, even though they have achieved mean glucose within the euglycemic range. Physical activity and sleep quality are important determinants of cardiometabolic health, however, the impact of these factors on glucose fluctuations is less documented. The objective was to assess the influence of physical activity and sleep quality on glycemic control and glycemic variability measured using a Continuous Glucose Monitoring System among adults with type 2 diabetes in India.

Methods: Adults with type 2 diabetes (n=8) received sensor-based FreeStyle Libre Pro glucose monitors to continuously measure interstitial glucose concentrations over a three consecutive day tracking period. A questionnaire was used to gather information on the socio-demographic characteristics and on the components of nutritional assessment. Hourly physical activities were self-recorded on a validated physical activity logbook and the sleep quality was estimated using the Pittsburg Sleep Quality Index (PSQI). Glycemic Variability was assessed by Standard Deviation (SD), Mean Amplitude of Glycemic Excursions (MAGE), Time in Range (TIR), Time Above Range (TAR) and Time Below Range; and glycemic control was determined by HbA1C values.

Results: The mean age was 55.2 (14.9) years. Indulging in any physical activity for at least 1 hour/d at 2.5 - 8 metabolic equivalent (MET) range was significantly associated with greater TIR (mean: 81.2 vs 15.9%), lower TAR (10.1 vs 83.5%), lower glycemic variability (mean SD: 38.3 vs. 56.71; mean MAGE: 100.13 vs 138) and better glycemic control (mean glucose: 130.62 vs 213.6 mg/dL; mean HbA1C: 7.5 vs 9.6%) as compared to only indulging in activities between 1 - 2.3 MET range. Participants with better sleep quality (PSQI ≤ 5) (4 (1.15)) showed greater TIR (mean: 63.6 vs 49.8%), lower TAR (mean: 28.8 vs 46.4%), lower glycemic variability (mean SD: 40 vs 50.4; mean MAGE: 100.17 vs 128) and lower 24-hour-mean glucose values (mean: 145.5 vs 177.3 mg/dL) as compared to those with poor sleep quality (10.75 (4.11)).

Conclusions: Lower physical activity levels and poor sleep quality were associated with larger glycemic variability, thus presenting potential behavioral change targets for better glycemic control and personalized diabetes management.

Funding Sources: None