1518-P: Exercise Snacks Can Alter Physical Activity Patterns and Increase Vigorous Activity in People Living with Type 2 Diabetes: Analyses of Three Randomized Trials

Introduction and Objective: Exercise snacks (ES) are a practical strategy to increase vigorous physical activity (VPA), yet their impact on accelerometer-derived activity metrics in people living with type 2 diabetes (T2D) is unknown. Methods: This study integrates findings from two randomized crossover studies (Studies 1 and 2) and a 12-week parallel-arm randomized control trial (Study 3). Studies 1 and 2 examined the acute effects of either vigorous-intensity ES (n=32; 57±11 year) or low-intensity stretching exercise (LIE) (n=38; 58±10 years) compared to no exercise. Participants completed two days with prescribed 4×1-minute bouts distributed throughout the day and two days without prescribed exercise. Study 3 aimed to compare ES (n=32) with LIE (n=35), performed ≥5 days/week. Thigh-worn activPAL4 accelerometers were used throughout Studies 1 and 2 and for seven consecutive days at Week 11 in Study 3, with data processed using GGIR. Effect estimates (% difference [95% CI]) were calculated for both studies. Results: In Study 1, ES produced a higher daily intensity distribution profile (IG, 10 [3,18], P=0.004), greater acceleration across the most active 1 minute to 120 minutes (MX metrics, all P<0.05), reduced time spent in the acceleration bin 0-50mg (1 [0, 2], P<0.001), and increased time in higher acceleration bins (all P<0.05) compared to no exercise. In Study 2, LIE increased average acceleration (17 [4, 31], P=0.011) and the IG (13 [2, 27], P=0.026) versus no exercise but did not alter MX metrics or time accumulated in acceleration bins. In Study 3, ES increased acceleration in the most active 1 minute to 60 minutes (P<0.05) and resulted in greater time accumulated in acceleration bins 150-200mg (42 [12, 79], P=0.004), 350-400mg (53 [23, 91], P<0.001), and >400mg (105 [62, 161], P<0.001) at Week 11 compared to LIE. Conclusion: Vigorous ES performed by people with T2D in a real-world setting increased accelerometer-derived VPA and shift activity profiles in a manner associated with health benefits. Disclosure R.E. Sandilands: None. A. Marcotte-Chénard: None. F.J. Babir: None. S.F. McCarthy: None. B.D. Maylor: Research Support; Current; Boehringer Ingelheim International GmbH. N. Mulkewich: None. A. D'Amico: None. H. Islam: None. M. Gibala: Stock/Shareholder; Current; Longevity League Ltd. Advisory Panel; Current; Longevity League Ltd. J. Little: None.