Supervised exercise program, BMI, and risk of type 2 diabetes in subjects with normal or impaired fasting glucose.
OBJECTIVE
To determine the association of regular exercise, BMI, and fasting glucose with the risk of type 2 diabetes and to predict the risk.


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.
Yonsei University Research Institute of Science for Aging, Yonsei University, Seoul, Korea.
Jey Sook
JS
Chae
Ryungwoo
R
Kang
Jung Hyun
JH
Kwak
Jean Kyung
JK
Paik
Oh Yoen
OY
Kim
Minjoo
M
Kim
Ji Won
JW
Park
Justin Y
JY
Jeon
Jong Ho
JH
Lee
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control*; D015444:Exercise / Q000502:physiology*; D005215:Fasting / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000503:physiopathology; D050177:Overweight / Q000503:physiopathology; D011446:Prospective Studies; D055105:Waist Circumference / Q000502:physiology
D001786:Blood Glucose