Combined Associations of Type 2 Diabetes and Peripheral Neuropathy With Device-Measured Physical Activity and Sedentary Behaviour—The Maastricht Study

Objective

Peripheral neuropathy (PN) is a common complication of type 2 diabetes mellitus (T2DM). In this study, we determined the independent and combined associations of T2DM and PN with device-based measures of physical activity levels and sedentary behaviour.

Materials and Methods

Cross-sectional data from The Maastricht Study were used (N: 6471, age 59.8 ± 8.8). T2DM was determined with an oral glucose tolerance test and PN was, using a neurothesiometer, defined as an impaired vibration perception threshold (iVPT), that is exceeding 25 V in either one or both halluces. Physical activity and sedentary behaviour outcomes were derived through 8 days of activPAL accelerometer measurement, worn 24 h/day. Multiple linear regression analyses were used with adjustment for demographic, lifestyle and health-related indicators.

Results

In the fully adjusted model, the combined presence of T2DM and iVPT presented the lowest step count (−1407 steps/day [95% CI: −1851, −963]), and showed the lowest time in light-intensity (−27.2 min/day [−38.6, −15.8]) and moderate-to-vigorous physical activity (−9.5 min/day [−12.6, −6.5]). Moreover, those with both conditions had the highest sedentary time (+33.3 min/day [21.4, 45.2]) and longest sedentary bout durations (+1.0 min/bout [0.6, 1.4) compared with those without these conditions.

Discussion

T2DM and PN were both independently associated with lower levels of physical activity and higher levels of sedentary time. The combination of T2DM with PN was associated with particularly low levels of physical activity and higher levels of sedentary time, indicating an additive association. Strategies to improve physical activity in these individuals should address both conditions.