Physical inactivity and prolonged sedentary behavior are major health concerns, especially for individuals with chronic conditions such as diabetes and prediabetes. Many patients have difficulty following traditional exercise recommendations due to time constraints, limited physical capacity, comorbidities, or lack of access to exercise facilities. Therefore, new and more practical exercise strategies are needed.

"Exercise Snacks" is a novel physical activity approach that involves short bouts of exercise performed multiple times throughout the day. Each session is brief and easy to integrate into daily life, such as performing short periods of resistance exercises, brisk walking, stair climbing, or other simple activities. This approach may improve exercise adherence and provide health benefits without requiring long exercise sessions.

The purpose of this study is to evaluate the feasibility and acceptability of an Exercise Snacks intervention in sedentary adults with diabetes or prediabetes and to explore its potential effects on cardiovascular and metabolic health, physical function, and body composition.

In this study, sedentary adults aged 18-65 years with diabetes or prediabetes will participate in a 12-week study and will be randomly assigned to either an Exercise Snacks group or a control group. Participants in the Exercise Snacks group will perform short exercise sessions lasting approximately 3-5 minutes, including simple resistance exercises and short aerobic activities. These exercise sessions will be performed several times per day and integrated into daily routines. The control group will maintain their usual lifestyle without additional exercise intervention.

Participants may use wearable devices or mobile applications to receive reminders and record exercise activity. Assessments will be conducted before and after the intervention to evaluate physical activity adherence, physical function, body composition, blood pressure, blood glucose, and other cardiovascular and metabolic health indicators.

This study aims to determine whether short, frequent exercise sessions are a practical and effective alternative to traditional exercise recommendations for sedentary individuals with diabetes or prediabetes. The results of this study may help develop more feasible lifestyle intervention strategies to improve long-term exercise adherence and overall health in individuals with chronic diseases.

Physical inactivity and prolonged sedentary behavior are recognized as major risk factors for cardiovascular disease, type 2 diabetes, obesity, and metabolic syndrome. Although current physical activity guidelines recommend at least 150 minutes of moderate-intensity exercise per week, many individuals with chronic conditions such as diabetes or prediabetes are unable to meet these recommendations due to time constraints, low exercise tolerance, comorbidities, or lack of access to exercise facilities. Therefore, alternative exercise strategies that are feasible, flexible, and sustainable are needed for sedentary populations with chronic diseases.

Exercise Snacks is an emerging exercise concept that involves performing short bouts of physical activity multiple times throughout the day rather than completing a single continuous exercise session. These short sessions typically last from 1 to 5 minutes and may include resistance exercises, stair climbing, brisk walking, or other moderate-to-high intensity activities. Previous studies suggest that accumulating short bouts of exercise throughout the day may improve glycemic control, cardiovascular fitness, muscle strength, and exercise adherence. However, the feasibility and acceptability of Exercise Snacks in sedentary individuals with diabetes or prediabetes remain insufficiently studied in clinical settings.

The primary aim of this study is to evaluate the feasibility and acceptability of an Exercise Snacks intervention among sedentary adults with diabetes or prediabetes. Secondary aims include evaluating the preliminary effects of the Exercise Snacks intervention on cardiovascular and metabolic health indicators, physical function, and body composition.

This study will recruit sedentary adults aged 18 to 65 years who have been diagnosed with diabetes or prediabetes. Participants will be randomly assigned to either the Exercise Snacks intervention group or the control group. The intervention period will last 12 weeks.

Participants in the Exercise Snacks group will perform short exercise sessions multiple times per day. Each exercise session will last approximately 3 to 5 minutes and will include simple resistance exercises (such as squats, split squats, resistance band exercises, and curl-ups) and short aerobic activities (such as brisk walking, stair climbing, running in place, or jumping jacks). Participants will be encouraged to perform at least 3 to 4 exercise sessions per day and integrate these activities into their daily routines. Exercise intensity and exercise type will be adjusted based on individual physical capacity and safety considerations.

Participants in the control group will maintain their usual lifestyle and will not receive the Exercise Snacks intervention during the study period.

Wearable devices or mobile applications may be used to provide exercise reminders, monitor exercise adherence, and record physical activity data. Assessments will be conducted before and after the 12-week intervention. Outcome measurements will include feasibility and acceptability questionnaires, physical function tests (such as the 6-Minute Walk Test and 3-Minute Step Test), body composition measurements (including body weight, body mass index, body fat percentage, muscle mass, waist circumference, and waist-to-hip ratio), and cardiovascular and metabolic indicators (including blood pressure, fasting blood glucose, and HbA1c).

The results of this study will help determine whether Exercise Snacks is a feasible and practical lifestyle intervention strategy for sedentary individuals with diabetes or prediabetes. This study may provide preliminary evidence for integrating short-duration, high-frequency physical activity into clinical lifestyle management programs for chronic disease populations.

Inclusion Criteria:

1. Age 18 to 65 years.
2. Diagnosed with diabetes mellitus (HbA1c ≥ 6.5%) or prediabetes (HbA1c ≥ 5.7%).
3. Engaging in less than 1 hour of physical activity per week in the past 3 months, assessed by the International Physical Activity Questionnaire (IPAQ).
4. Sedentary behavior defined as sitting for ≥ 6 hours per day or walking fewer than 5,000 steps per day on average.
5. Able to use a smartphone and operate related mobile applications.
6. Able to provide informed consent and willing to participate in the study.

Exclusion Criteria:

1. History of heart disease, kidney disease, pregnancy, cancer, lower limb joint disease, or psychiatric disorders.
2. Musculoskeletal or neurological disorders that limit independent physical activity or exercise.
3. Acute or terminal illness that may affect participation in the study, such as ongoing cancer treatment, acute myocardial infarction, acute stroke, or receiving palliative care.
4. Unstable or uncontrolled cardiovascular, metabolic, or respiratory diseases, such as unstable angina, uncontrolled hypertension (systolic blood pressure ≥ 180 mmHg), heart failure, severe chronic obstructive pulmonary disease, or acute exacerbation of respiratory disease.
5. Presence of metal implants in the body.
6. Body mass index (BMI) ≥ 35 kg/m².
7. Unable to use a smartphone or mobile applications.

Individual participant data will not be publicly available due to participant privacy and confidentiality considerations. However, de-identified data may be available from the study investigators upon reasonable request and subject to institutional approval.