Supervised exercise program, BMI, and risk of type 2 diabetes in subjects with normal or impaired fasting glucose

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From: Diabetes Care(Vol. 35, Issue 8)
Publisher: American Diabetes Association
Document Type: Article
Length: 3,949 words
Lexile Measure: 1500L

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OBJECTIVE--To determine the association of regular exercise, BMI, and fasting glucose with the risk of type 2 diabetes and to predict the risk.

RESEARCH DESIGN AND METHODS--Korean subjects (n = 7,233; 40-79 years old) who were not diagnosed with diabetes at baseline were enrolled through the National Health Insurance Corporation. All participants underwent biennial examinations, and 1,947 of 7,233 subjects also underwent a 6-month program of moderate-intensity exercise (300 min/week) without dietary advice.

RESULTS--During follow-up (mean = 2 years), there were 303 incidents of type 2 diabetes in the nonexercise program group (n = 5,286) and 83 in the exercise program group (n = 1,947). After adjusting for confounders, the risk of type 2 diabetes was positively associated with BMI and inversely with regular exercise, especially among overweight/obese subjects. After further adjustment for BMI, the odds ratios for risk of diabetes associated without and with regular exercise were 1.00 and 0.77, respectively. Among subjects with normal fasting glucose, exercise reduced the diabetes risk; however, among those with impaired fasting glucose (IFG), the protective effect of exercise was found only among overweight/obese subjects. The overweight/obese subjects in the exercise program group exhibited improved fasting glucose compared with the nonexercise program group and showed 1.5 kg of weight loss and a 3-cm decrease in waist circumference. Among overweight/obese subjects with unchanged fasting glucose, weight loss was greater in the exercise program group.

CONCLUSIONS--Regular exercise reduces the risk of type 2 diabetes in overweight/obese individuals. Particularly, regular exercise and weight or waist circumference control are critical factors for preventing diabetes in overweight/obese individuals with IFG.

The benefits of exercise in preventing and treating type 2 diabetes are widely recognized (1). Exercise improves glycemic control, body composition, cardiorespiratory fitness, cardiovascular risk, physical functioning, and well-being in patients with type 2 diabetes or prediabetes (1-3). Regular exercise is therefore a key strategy in diabetes prevention. A number of large-scale, randomized, controlled trials have been performed to evaluate the effect of lifestyle modification in prediabetic populations (4-10), with the aim of reducing the incidence of type 2 diabetes and ameliorating risk factors associated with this disease. These lifestyle interventions, which generally included both physical activity and nutritional interventions, have been highly successful in preventing the onset of type 2 diabetes. Studies that failed to show improved glycemic control typically reported poor exercise compliance (11) or low-intensity exercise (12). However, most physical activity intervention studies focused on English speakers. Additional studies are needed to characterize ethnic and/or cultural differences in the risk of type 2 diabetes because most studies show lower physical activity levels in nonwhite compared with white populations (13). Accordingly, tailor-made interventions that take into account the different needs of various groups (e.g., language and culture) should be developed and evaluated. In this prospective cohort study, we evaluated the association of regular exercise, BMI, and glucose levels with the risk of type 2 diabetes in a Korean population. The exercise program was prescribed and delivered by qualified health professionals.


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Gale Document Number: GALE|A299885907