The temporal interplay between physical activity, emotional well-being, and health-related quality of life in individuals with recently diagnosed type 2 diabetes mellitus: a cross-lagged panel analysis

AIMS: We investigated longitudinal, bidirectional associations between objectively measured moderate to vigorous physical activity (MVPA), health-related quality of life (HRQoL), and emotional well-being (EWB) in individuals recently diagnosed with type 2 diabetes mellitus. METHODS: Participants were 972 adults. MVPA was assessed using accelerometry, HRQoL using the SF-12 (physical [PCS], mental [MCS]), and EWB using the WHO-5. A three-wave cross-lagged panel model tested associations, adjusting for age and sex. RESULTS: Baseline PCS predicted MVPA at 24 months (β = 0.124, p < 0.001), and PCS at 24 months predicted MVPA at 48 months (β = 0.146, p < 0.001). Baseline MCS predicted MVPA at 24 months (β = 0.116, p = 0.001), but not 48 months (β = -0.016, p = 0.653). Baseline EWB predicted MVPA at 24 months (β = 0.080, p = 0.023), but not 48 months (β = 0.068, p = 0.058). Baseline MVPA did not predict PCS at 24 months (β = 0.038, p = 0.184), but MVPA at 24 months predicted PCS at 48 months (β = 0.065, p = 0.024). MVPA did not predict MCS or EWB. CONCLUSIONS: HRQoL and EWB predicted subsequent MVPA, whereas MVPA showed limited and inconsistent effects on later HRQoL or EWB.