Exercise snacks are feasible to perform in the real world and improve physical capacity for adults living with non-insulin treated type 2 diabetes: a randomized trial

Aims/hypothesisTo investigate the feasibility and preliminary efficacy of a 12-week remotely-delivered exercise snacks (ES) intervention in adults with type 2 diabetes. MethodsInsufficiently active adults with type 2 diabetes (N=69; 46 females; mean age {+/-} SD: 58{+/-}11 years) were randomized to an ES or mobility/stretching comparator group (CON), which involved 4 x 1-min bouts of either vigorous or low intensity exercise, respectively, on [&ge;]5 days/week. The primary outcome was feasibility based on adherence. Secondary outcomes included exercise enjoyment (1-7 scale), rating of perceived exertion (RPE; 0-10 scale), heart rate (HR), hemoglobin A1c (HbA1c), blood biomarkers of cardiometabolic health, 30-second sit-to-stand capacity, grip strength, estimated maximal oxygen uptake, and anthropometrics. ResultsWeekly adherence (estimated marginal mean [95% confidence interval]: 18 bouts [16 to 21] for both groups; P=0.99) and total enjoyment (ES: 4.5 [4.1 to 4.8] vs CON: 4.3 [4.0 to 4.7]; P=0.64) were high and not different between groups. Despite higher RPE (5.7 [5.4 to 6.1]) and peak HR (73 [70 to 77] % of age-predicted HR maximum) in ES vs CON (2.0 [1.7 to 2.4] and 61 [58 to 64] % of age-predicted HR maximum, respectively) (all P<0.001), there were no between-group differences in the change in any secondary outcome (all P>0.05) except for greater sit-to-stand capacity in ES after training (between-group effect estimate [95% confidence interval]: 1.9 repetitions [0.3 to 3.4]; P=0.02). Conclusions/interpretationExercise snacks were feasible to perform in the real-world and improved physical capacity to a greater extent than CON in adults living with type 2 diabetes. Trial registrationClinicalTrials.gov ID: NCT06407245 Research in ContextO_ST_ABSWhat is already known about this subject?C_ST_ABSO_LIExercise snacks ([&le;]1-min bouts of vigorous exercise spaced out across the day) are a time-efficient and practical approach to promote vigorous exercise and break up sedentary time. C_LIO_LIReal-world exercise snack interventions appear feasible for middle-aged and older adults. C_LI What is the key question?O_LIAre 12 weeks of exercise snacks performed in the real-world feasible for insufficiently active adults living with non-insulin treated type 2 diabetes? C_LI What are the new findings?O_LIExercise snacks are feasible for those living with type 2 diabetes to perform unsupervised in the real-world based on high adherence, enjoyment, and participant retention rates. C_LIO_LIExercise snacks improved 30-second sit-to-stand capacity and reduced waist circumference suggesting enhancements in physical capacity and body composition. C_LI How might this impact on clinical practice in the foreseeable future?O_LIExercise snacks could be utilized to help individuals living with type 2 diabetes build a routine or habit of incorporating small amounts of physical activity into their daily lives. C_LIO_LIThe improved physical capacity observed in the current study could contribute to lower fall risk and greater lower body strength in those with type 2 diabetes as they age. C_LI