Objectively measured sleep and health-related quality of life in older adults with type 2 diabetes: a cross-sectional study from the Alberta's Caring for Diabetes Study.

BACKGROUND AND AIM: Sleep is an important behavior for metabolic control and mental health in type 2 diabetes. The aim was to examine the relationship of objective estimates of sleep quantity and quality with health-related quality of life (HRQL) in adults with type 2 diabetes. MATERIALS AND METHODS: Participants completed a survey where HRQL was measured using the EQ-5D-5 L index score, and the SF-12 v2, which provides physical and mental composite summary (PCS and MCS) scores. Participants also wore wrist actigraphy (Actigraph GT3X+) during sleep to derive estimates of total sleep time (TST), sleep latency (SLAT), and sleep efficiency (SEFF) and wake after sleep onset (WASO). Adjusted multivariable linear regression models were used to examine the associations among actigraphy-derived sleep parameters with PCS, MCS, and EQ-5D-5 L index scores. RESULTS: On average, participants (N=168) were 65 years old (standard deviation [SD] 10), 46% were female, with a diabetes duration of 13 years (SD 9) and body mass index of 31 kg/m2 (SD 6.5). Mean (SD) TST and SLAT were 7.5 (1.0) hours and 9.9 (7.6) minutes, respectively, SEFF was 82.7 (6.1) percent and WASO was 86.7 (53.4) minutes. An inverse association between TST and PCS was found where every additional 60 minutes of sleep was associated with 1.3-unit lower PCS (P=.04). SEFF was positively associated with both PCS and MCS, where a 10% greater SEFF was associated with 2.6-unit higher PCS (P=.008), and 1.8-unit higher MCS (P=.056). CONCLUSIONS: Among this population, better sleep efficiency was associated with better physical and mental health.

Physical Activity and Health-Related Quality of Life in Adults With Type 2 Diabetes: Results From a Prospective Cohort Study.

BACKGROUND: The objective was to investigate the longitudinal relationship between physical activity and health-related quality of life (HRQL) in adults with type 2 diabetes. METHODS: Data were from a prospective cohort of adults with type 2 diabetes. Weekly moderate-to-vigorous physical activity (MVPA) was reported using the Godin Leisure-Time Physical Activity Questionnaire, and HRQL was reported using the SF-12 and 5-level EQ-5D. Participants were categorized based on current weekly MVPA recommendations. Multivariable linear regression was used to explore associations between MVPA and HRQL, and multinomial logistic regression was used to assess the direction of change in HRQL after 1 year. RESULTS: Mean age of participants (N = 1948) was 64.5 ± 10.8 years and 45% were female. Participants reported a mean of 84.1 ± 172.4 min of MVPA/week, and 21% (n = 416) met weekly MVPA recommendations. MVPA was associated with differences in the physical functioning (b = 5.42; P < .001), general health (b = 2.45; P = .037), and vitality (b = 2.83; P = .016) SF-12 dimensions. Participants who met recommendations were less likely to report a decline (vs. no change) in EQ-5D index score (OR = 0.75; 95% CI [0.57, 0.99]), and SF-12 physical component summary (OR = 0.67; 95% CI [0.50, 0.90]), compared with participants not meeting recommendations. CONCLUSIONS: Participants who met weekly MVPA recommendations reported better physical functioning and were more likely to maintain their physical and overall HRQL over time.

Association between Physical Activity and Health-Related Quality of Life in Adults with Type 2 Diabetes.

OBJECTIVES: To examine the association between meeting physical-activity recommendations and health-related quality of life (HRQL) in adults with type 2 diabetes. METHODS: Data from the Alberta's Caring for Diabetes cohort were used. Self-report questionnaires were mailed to patients with type 2 diabetes who were living in Alberta, Canada. Weekly moderate-vigorous physical activity (MVPA) was reported using the Godin Leisure Time Physical Activity Questionnaire, and HRQL was reported using the Medical Outcomes Study (MOS) 12-Item Short-Form Health Survey v. 2 (SF-12 v. 2) and the 5-level EuroQol 5-Dimensions (EQ-5D). Based on current guidelines for patients with type 2 diabetes in Canada, participants were grouped according to whether they accrued 150 minutes of MVPA per week. Multivariable linear regression models were used to explore associations between physical activity and HRQL. RESULTS: The mean age of participants (N=1948) was 64.5±10.8, and 45% were female. Participants reported a mean of 84.1±172.4 minutes of MVPA per week, and 21% (n=416) met recommendations for physical activity. Those who met physical activity recommendations reported higher scores on physical functioning (b=9.58; p<0.001); role-physical (b=8.87; p=0.001); bodily pain (b=5.12; p=0.001); general health (b=6.66; p<0.001); vitality (b=9.05; p<0.001); social functioning (b=3.32; p=0.040); and role-emotional (b=3.08; p=0.010); physical component summary (b=3.31; p<0.001); mental component summary (b=1.43; p=0.001) and EQ-5D-5L index score (b=0.022; p=0.005) compared to those not meeting recommendations. CONCLUSIONS: The majority of the sample did not meet the guidelines for physical activity. Among those who did, a significant positive association was observed with HRQL, particularly physical health.