Evaluation of relationship between chronotype, nutritional status, physical activity and blood glucose in individuals with type-2 diabetes

In this study, it was aimed to evaluate the relationship between the determined chronotypes of individuals with Type 2 diabetes and nutritional status, physical activity and blood glucose levels. The study was conducted with 75 Type 2 diabetes patients aged between 19-64 years who applied to Başkent University Ankara Hospital Endocrinology and Metabolism Diseases Polyclinic between February 2022 and May 2022. 34 (45%) of the patients were male, 45 (55%) were female, and their mean age was 55.57±8.13 years. A questionnaire consisting of 5 parts was applied to the patients. The questionnaire includes socio-demographic information, anthropometric measurements, Morning-Evening Questionnaire, three-day food consumption registration form, International Physical Activity Questionnaire-Short Form and a table in which some blood glucose values obtained from the patient information system are recorded. When the chronotype scores were classified, it was seen that 62.7% of the patients were in the intermediate class, 6.7% in the evening class, and 30.7% in the morning class. No significant differences were found between the chronotype scores of the patients according to their socio- demographic characteristics (gender, age group, marital status, education level, income status and employment status) (p>0.05). Anthropometric characteristics and Morningness- Eveningness Questionnaire scores were not found to be correlated. (p>0.05). Morning- Evening questionnaire scores, MET-minutes/week, HbA1c (p>0.05) and fasting blood glucose (p<0.05) values were found to be higher in males compared to females. According to BMI examinations, chronotype scores of owerweight individuals are higher than others (p>0.05). There was a positive correlation between the Morningness-Eveningness Questionnaire scores of the patients and their fiber and fiber types (g), and folate (mcg) intakes; negative correlations were found between protein (TE%) intakes and Morningness- Eveningness Questtionare (p<0.05). There was a positive correlation between Morningness- Eveningness Questionnaire scores and sucrose intakes; a negative correlation was found between protein (TE%) intakes and Morningness- Eveningness Questionnaire of female patients. (p<0.05). There was no significant difference between the amount of energy and macronutrient intake according to the chronotype class (p>0.05). The folate (mcg) intake of the individuals in the morning group was higher than the others (p<0.05), and no significant difference was observed between the groups in terms of other micronutrient intakes (p>0.05). According to the MET-minute/week calculated by the International Physical Activity Questionnaire-Short Form, 45% of the patients are in the inactive, 44% minimally active and 11% very active class. The relationship between the MET-minute/week value and the Morning-Evening Questionnaire score was found to be insignificant (p>0.05). Calculated MET-minute/week values of the evening type individuals were found to be lower than the others (p>0.05). The mean fasting blood glucose of the Type 2 diabetes patients in the study was 139.45±55.48 mg/dL, and the mean HbA1C (%) was 7.12%±1.78%. No significant correlation was found between Morning-Evening Questionnaire scores and HbA1c (%) and fasting blood glucose values (p>0.05). The fasting blood glucose and HbA1c averages of the individuals in the evening group were higher (p>0.05). As a result, chronotype score has a relationship with protein, fiber and folate intakes. The mean chronotype score was found to be higher in patients in the evening group. Chronotypes of patients with type 2 diabetes should be determined by means of the morningness-eveningness questionnaire, and if it is evening type, information should be given. Components such as shifting energy intake to daytime, determining the right time for physical activity, and arranging training-working hours can be added to the treatment protocol in patients who are found to be evening type.