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Can reducing sitting time influence sustained glycaemic control in middle-aged and older office workers with type 2 diabetes?

Project leaders: Professor David Dunstan

Diabetes is a national health priority area and the sixth leading cause of death in Australia. Currently 280 Australians develop diabetes every day — that is one person every five minutes. Type 2 diabetes (T2D) prevalence is high among middle-aged and older (45–65 years) workers &mdash up to 7.7 per cent — with a substantial impact on work productivity, risk of absenteeism and inability to work. Cardiovascular disease (CVD) is the most common long term complication of T2D, predominantly related to chronic hyperglycaemia. One potential strategy to address this risk is through reducing and breaking up prolonged sitting time: a strategy which has been demonstrated to be effective and acceptable in adults with T2D — at least acutely. What is now required is evidence from NHMRC Level II efficacy trials on the long term impact of reducing and breaking up sitting time in the vulnerable population we propose to study — middle-aged and older office workers with T2D.

Our proposal: a randomised controlled trial for office workers with T2D

This will be the first rigorously controlled field-based trial to examine the effects of reducing and breaking up prolonged sitting time on glycaemic control in office workers with T2D. It draws and builds on two main strands of our research. The first is our world-leading Stand Up Australia program of studies, which have demonstrated substantial (>1.3 hrs–16hr day) reductions in overall sitting time in general adult working populations using multi-component interventions similar to what we propose here. It also builds on the findings from our laboratory studies at the Baker Institute, showing that substantial (↓ 39%) reductions in postprandial glucose (PPG; a significant contributor to overall glycaemic control — HbA1c) can be acutely [1-day] achieved by reducing and interrupting prolonged sitting time. To date, all of the published trials describing the beneficial effects of breaking up sitting time on PPG have been restricted to acute exposure periods (1–5 days). Given that almost all such acute experimental studies have been conducted in laboratory settings, there is a need to experimentally test whether these changes are possible within everyday life settings and over longer time periods. This is crucial for understanding the potential of this approach for clinical and public health translation. We propose a pragmatic trial of an intervention that has the potential for immediate real-world applicability. It is novel in that it specifically addresses new and emerging health threats as outlined in the NHMRC Strategic Direction 2015–16 to 2018–19: address the social, environmental and community dimensions of health, with prolonged sitting due to technological and economic changes being the case in point.

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