Sleep patterns, physical activity and glycemic control in newly diagnosed type 2 diabetes patients from a joint perspective: a cross-sectional study.

Background: The newly diagnosed stage of type 2 diabetes mellitus (T2DM) represents a "critical window" for delaying disease progression through lifestyle intervention. Insufficient physical activity and sleep disorders are both known risk factors for metabolic disorders. However, evidence regarding the independent and combined effects of sleep patterns and physical activity on weekdays and weekends in newly diagnosed patients is currently lacking. Methods: This study employed a cross-sectional design and included 340 patients with newly diagnosed type 2 diabetes who had not received any hypoglycemic medical treatment previously. The average sleep duration on weekdays and weekends was collected through standardized sleep diaries, and the physical activity level was calculated in metabolic equivalents (METs) using the long-form International Physical Activity Questionnaire (IPAQ). Multivariate linear regression models and generalized additive models were performed to analyze the associations between sleep, physical activity, fasting blood glucose, and glycated hemoglobin. A combined grouping variable of sleep and physical activity was constructed to evaluate the potential interaction effects. Results: We found that there was a statistically significant U-shaped association between sleep duration on weekdays and fasting blood glucose (p < 0.05), with the optimal point at around 6.92 hours. Physical activity could be a protective factor for glycemic control. Compared with the low-activity group, both moderate-intensity and high-intensity activities were significantly associated with lower fasting blood glucose (β = -2.76 and -3.22) and glycated hemoglobin (β = -1.50 and -2.01) levels, but there was no significant difference observed when comparing the moderate- and high-intensity activity groups. The interaction analysis of the groups shown that moderate to high-intensity physical activity may have promising glycemic control effects. On weekdays, "moderate sleep & high physical activity" (β = -3.57, p < 0.001) and on weekends, "long sleep & high physical activity" (β = -4.25, p < 0.001) respectively showed a potential notable glycemic control benefits. Conclusion: In newly diagnosed type 2 diabetes patients, maintaining a sleep duration of approximately 7 hours​ on workdays and engaging in at least moderate-intensity physical activity are associated with​ better early glycemic control. Moderate- to high-intensity physical activity is crucial and may partially offset the adverse glycemic effects of insufficient sleep.