Balducci S, Haxhi J, Sacchetti M, et al. - Findings demonstrate a likely clinically meaningful influence of even modest increases in moderate- to vigorous-intensity physical activity (MVPA) in patients with type 2 diabetes. Also, reallocating sedentary time (SED-time) to light-intensity physical activity (LPA) could contribute to improved results, probably by increasing total energy expenditure.

• A 3-year randomized clinical trial to determine the associations of alterations in physical activity (PA)/SED-time with changes in physical fitness and cardiometabolic risk profile in people with type 2 diabetes.

• A total of 300 physically inactive and sedentary patients were randomly assigned 1:1 to receive 1-month theoretical as well as practical counseling once a year or standard care.

• With quartiles of MVPA and SED-time change, increase in physical fitness as well as reduction in HbA _1c and coronary heart disease 10-year risk scores was noted.

• Increase in cardiorespiratory fitness by 5.23 and 4.49 mL ⋅ min ⁻¹ ⋅ kg ⁻¹ and reduction in HbA _1c by 0.73 and 0.85% was observed in quartile IV of MVPA increase and SED-time decrease, respectively.

• These links were corroborated by univariate correlations, and mean alterations in both MPVA and SED-time were found to be predictive of alterations in physical fitness and cardiovascular risk factors/scores, independently of one another and of other confounders.

• Similar results were noted with LPA and PA volume as well as in each group separately.