Efficacy of Exercise Snacks in Real-World Settings in Individuals Living With Type 2 Diabetes

To conduct a pilot randomized control trial to determine the feasibility of a 12-week, technology-enabled exercise snacks intervention in adults living with type 2 diabetes in a real-world setting. We will also assess preliminary efficacy based on measures of glycemic control and fitness.

Study Overview

• Status: Recruiting
• Conditions: Type 2 Diabetes
• Intervention / Treatment: Other: Exercise Snacks; Other: Placebo Exercise

Detailed Description

Participants will be randomized into an Exercise Snacks or a Placebo Exercise group for 12 weeks. The former will involve bodyweight exercises performed with vigorous effort and the latter will involve low-intensity exercises. Following baseline testing, individualized interventions will be delivered at home or work via customized mobile application ("app") or web platform. Participants will be instructed to perform a minimum of 4 isolated bouts of prescribed exercises per day on at least 5 days per week. Each bout will be one minute in duration. The interventions will be individualized and consider exercise preferences and physical abilities (e.g., fitness, musculoskeletal issues), and be adaptable to multiple environments (e.g., home, work). To facilitate this, participants will have a pre-intervention meeting wherein any physical limitations will be documented, and a research assistant will discuss the prescribed intervention and determine when and where the participants will plan to perform their exercises. After 12 weeks, participants will be asked to return to the lab for follow-up testing.

• Study Type: Interventional
• Enrollment (Estimated): 80
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Jonathan P Little, PhD; Phone Number: 250.807.9876; Email: jonathan.little@ubc.ca

Study Locations

• Canada
  • British Columbia
    • Kelowna, British Columbia, Canada, V1V 3G1
      • Recruiting
      • University of British Columbia Okanagan
      • Contact: Jonathan Little, PhD; Phone Number: 2508079876; Email: jonathan.little@ubc.ca
      • Contact: Phone Number: 2508079876; Email: jonathan.little@ubc.ca

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

1. Aged 30-75 years.
2. Have physician-diagnosed type 2 diabetes.
3. Physically inactive (performing <150 min moderate-to-vigorous physical activity per week).
4. Body mass index: 18.5-40 kg/m2.
5. Taking ≤3 glucose-lowering medications (excluding insulin) and stable dose for > 6 months.
6. Taking ≤2 commonly prescribed cardiovascular medications (e.g., statins, antihypertensive).
7. HbA1c ≤8.5%.
8. Able to maintain current physical activity patterns during the study.
9. Cleared to engage in physical activity using the Get Active Questionnaire and, if applicable, consultation with a health care provider or Qualified Exercise Professional.
10. Access to a computer, tablet or smartphone for intervention delivery and tracking.
11. Ability to read and write in English.

Exclusion Criteria:

1. Chronic musculoskeletal condition or recent (within 2 years) cardiovascular event preventing participation in exercise.
2. Lack of internet access.
3. Angina upon exertion assessed by the Rose Angina Questionnaire.
4. Prescribed beta-blockers that can compromise the validity of heart rate measurements. during the submaximal exercise test.
5. Have uncontrolled high blood pressure (hypertension; ≥ 160/90 mmHg) or an atypical blood pressure or pulse rate at rest or during exercise as determined by a physician.
6. Have a scheduled surgical procedure within the next 3-4 months that would prevent exercise participation.
7. Currently diagnosed with a cardiac or pulmonary disease (e.g., angina, arrythmia, exercise-induced bronchospasm) that would prevent exercise participation.
8. Have a psychiatric disorder that could prevent you from completing the study procedures or visits.
9. Have donated more than 0.5 L of blood within the last 4 weeks.
10. Currently following an extreme diet (e.g., very low carbohydrate/calorie, ketogenic) or taking dietary/nutritional supplements that impact glucose control (e.g., exogenous ketones).
11. Currently have diabetic ulcers, peripheral vascular disease, or diabetic neuropathy that will prevent participation in exercise.
12. Currently participating in another clinical trial that interferes with the study procedures.
13. Currently on dialysis.
14. Currently pregnant or planning on becoming pregnant during the intervention (i.e., within the next 4 months).
15. Have had an episode of severe hypoglycemia in the past 6 months (defined as having neurological symptoms consistent with neuroglycopenia and required assistance in treatment by a second party).

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Exercise Snacks; Vigorous-intensity bodyweight exercises performed 4 times per day on at least 5 days per week.	Other: Exercise Snacks; The "movement breaks" will be individualized to exercise preferences and physical abilities (e.g., fitness, musculoskeletal issues) and adaptable to multiple environments (e.g., home, work) delivered via mobile phone application.
Active Comparator: Placebo Exercise; Low-intensity stretching exercises performed 4 times per day on at least 5 days per week.	Other: Placebo Exercise; The "movement breaks" will be individualized to exercise preferences and physical abilities (e.g., fitness, musculoskeletal issues) and adaptable to multiple environments (e.g., home, work) delivered via mobile phone application.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Determine the number of individuals living with type 2 diabetes that are eligible to participate in the trial	The number of participants approached and reasons for not joining the study.	NA (recruitment period)
Determine the number of eligible individuals who would be willing to take part in this trial	The number of patients who enrol.	NA (recruitment period)
Determine the number and percentage of participants retained after the 12-week intervention	Number and percentage of patients who drop-out and reasons.	after the 12-week intervention
Determine the number of one-minute exercise bouts performed during the 12-week intervention	Number of exercise bouts performed each week of the intervention.	during the 12 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in glycated hemoglobin measured before and after the 12-week intervention	Glycated hemoglobin (A1c) at baseline and after 12 weeks.	0-12 weeks
Change in fasting glucose measured before and after the 12-week intervention	Fasting glucose measured at baseline and after the 12-week intervention.	0-12 weeks
Change in fasting insulin measured before and after the 12-week intervention	Fasting insulin measured at baseline and after the 12-week intervention	0-12 weeks
Change in 24h glucose concentration	Average of 24h glucose value measured with continuous glucose monitor at week 0 and week 11 of the intervention.	before (week 0; before the intervention) and week 11 of the intervention
Change in cardiorespiratory fitness measured before and after the 12-week intervention	Submaximal YMCA cycle ergometer test to estimate VO2 peak.	0-12 weeks
Change in lower body muscular endurance measured before and after the 12-week intervention	The 30-second sit-to-stand pre- and post-intervention.	0-12 weeks
Change in upper body maximal strength measured before and after the 12-week intervention	Grip strength test using a hand dynamometer pre- and post-intervention	0-12 weeks
Change in body composition measured before and after the 12-week intervention	Waist circumference, weight and body mass index assessed pre- and post- intervention.	0-12 weeks
Change in blood pressure measured before and after the 12-week intervention	Seated systolic and diastolic blood pressure measured before and after the 12-week intervention.	0-12 weeks
Change in blood lipid profile measured before and after the 12-week intervention	Total cholesterol, high-density lipoprotein (HDL) cholesterol, Non-HDL cholesterol, low-density lipoprotein (LDL) cholesterol, and Triglycerides.	0-12 weeks
Change in complete blood count measured before and after the 12-week intervention	Red blood cells, white blood cells, haemoglobin, haematocrit, and platelet.	0-12 weeks
Change in plasma inflammatory cytokines measured before and after the 12-week intervention	TNF-α, IL-6, IL-10, CRP	0-12 weeks
Change in health-related quality of life measured before and after the 12-week intervention	Euro Quality of Life 5 Dimension 5 Level (EQ-5D-5L) questionnaire pre- and post-intervention	0-12 weeks
Changes in diabetes distress measured before and after the intervention 12-week intervention	Diabetes Distress Scale (DDS) questionnaire pre- and post-intervention	0-12 weeks

Collaborators and Investigators

• Sponsor: University of British Columbia
• Collaborators: McMaster University
• Investigators: Principal Investigator: Jonathan Little, PhD, University of British Columbia

Study record dates

Study Major Dates

• Study Start (Actual): April 20, 2024
• Primary Completion (Estimated): July 19, 2025
• Study Completion (Estimated): July 19, 2025

Study Registration Dates

• First Submitted: April 19, 2024
• First Submitted That Met QC Criteria: May 6, 2024
• First Posted (Actual): May 9, 2024

Study Record Updates

• Last Update Posted (Actual): May 9, 2024
• Last Update Submitted That Met QC Criteria: May 6, 2024
• Last Verified: May 1, 2024

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Glucose Metabolism Disorders; Metabolic Diseases; Endocrine System Diseases; Diabetes Mellitus; Diabetes Mellitus, Type 2
• Other Study ID Numbers: H24-03417

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No