Objectives – T2D

The University of Rome “Foro Italico” and the University of Sheffield are coordinators of Workpackage 5 (WP5): “Modeling the effects of physical activity in T2D”.

 The role of exercise and physical activity in the prevention and control of insulin resistance, prediabetes, gestational diabetes, T2D, and diabetes related health complications have been widely recognized. Whereas the concept of exercise is associated with supervised training administered in controlled environments, physical activity refers also to simple activities like walking. Exercise intensity is typically measured in kilocalories burned per minute of activity or in a unit called the metabolic equivalent (MET), defined as the ratio of the metabolic rate during exercise to the metabolic rate at rest. This information, however, is not easily measurable on a large number of patients, nor in daily living situations. Conversely from exercise intensity variables, physical activity can be monitored also in real life situations, and can be quantified with simple information, such as the number of steps walked per day. Typical physical activity interventions in T2D entail asking patients to walk at least 10,000 steps/day. Cohort studies consistently show a marked reduction in the incidence of type 2 diabetes among physically active individuals compared with their

sedentary peers, and recent investigations provide empirical support for the prescription of 30 min/day of moderate-intensity activity. Observational and clinical trial data suggest that as little as 30 min/day of moderate-intensity physical activity can reduce the incidence of type 2 diabetes and cardiovascular events.

The mechanisms that underlie these protective effects likely include the regulation of body weight; the reduction of adiposity, insulin resistance, blood pressure, dyslipidemia, and inflammation; and the enhancement of insulin sensitivity, glucose tolerance, and fibrinolytic and endothelial function. Physical activity has already been proven to affect different variables of interest for this project.

To the best of our knowledge, despite the large number of studies available in the literature, the various relationships that have been established between physical activity and T2D related variables have not been systematized yet. However, they must certainly be taken into account when dealing with a better understanding of the phenomena of T2D onset and the identification of T2D early diagnostic parameters and related inflammatory indicators. The devise of a model that, as a part of the integrated modeling platform, takes into account for these aspects in defining the patient’s individualized context is certainly the key innovation point of this work package.

Objectives:

a) Devise a model of the effects of the physical activity level in T2D.

b) Integrate the model in the overall workflow.

c) Contribute to validating the model in the integrated workflow.

d) Contribute to implementing the aspects of the model related to physical activity measurements in the mobile app.