Abnormal 24-hour activity–rest patterns were associated with an increased risk of developing T2DM and subsequent mortality. The study, published in Nutrition & Diabetes, analyzed data from 74,165 adults without baseline diabetes in the UK Biobank cohort. Accelerometer-derived measures characterized CRAR based on amplitude, acrophase, pseudo-F, and mesor values using an extended cosine model.

During a median follow-up of 7.9 years, 1,784 participants developed T2DM. Multivariate-adjusted hazard ratios were 1.48 (95% CI, 1.31–1.67) for low amplitude, 1.25 (1.07–1.45) for delayed acrophase, 1.17 (1.04–1.31) for low pseudo-F, and 1.55 (1.38–1.74) for low mesor. Both low amplitude and low mesor were also linked to increased all-cause mortality after diabetes onset. Mediation analysis identified serum vitamin D as a principal factor in these associations.

The findings highlight the prognostic value of circadian rhythm integrity for metabolic health. Maintaining consistent daily activity and sleep patterns may lower diabetes risk and improve long-term outcomes.