title: Change in daily ambulatory activity and cardiovascular events in people with impaired glucose tolerance.
abstract: Patients with pre-diabetes have a tenfold higher risk of developing Type 2 DM and a twofold higher risk of developing coronary heart disease compared to non-diabetics. Interventions targeted at those in an early stage of impaired glucose metabolism can delay or prevent diabetes. Effects of these interventions on cardiovascular outcome are unknown. This article aims to review current and available data on lifestyle intervention, specifically physical activity, on cardiovascular outcomes in populations at risk for diabetes. We searched PubMed database from 1990 to present with focus on more recent literature published over the last 2 years. Various permutations of keywords used included glucose intolerance, pre-diabetes, diabetes, lifestyle modifications, physical activity, and cardiovascular disease. Intensive glycemic control, specific medications, and lifestyle intervention including increase in physical activity have been evaluated in diabetes and pre-diabetes. Most studies we reviewed showed that these interventions prevented progression of pre-diabetes to diabetes and improved cardiovascular risk surrogate measures. Direct decrease in cardiovascular mortality, non-fatal stroke, and non-fatal myocardial infarctions was shown in one recent trial. Increase in physical activity has a positive effect on decreasing cardiovascular risk by modifying several important risk factors and may decrease risk of events in pre-diabetics. More randomized high power trials are needed to verify and characterize these effects.
authors: Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX, 79905, USA.
authors: Maryna
authors: M
authors: Popp Switzer
authors: Sherif
authors: S
authors: Elhanafi
authors: Zinnia T
authors: ZT
authors: San Juan
mesh_terms: D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D003925:Diabetic Angiopathies / Q000209:etiology / Q000517:prevention & control; D018149:Glucose Intolerance / Q000150:complications*; D006801:Humans; D008019:Life Style; D009043:Motor Activity / Q000502:physiology*; D011236:Prediabetic State / Q000150:complications
references: Lancet. 2000 Jan 22;355(9200):253-9
references: 10675071
references: Circulation. 2003 May 20;107(19):2435-9
references: 12719277
references: Lancet. 2006 Nov 11;368(9548):1673-9
references: 17098085
references: Ann Intern Med. 2013 Oct 15;159(8):543-51
references: 24126648
references: Cochrane Database Syst Rev. 2008 Jul 16;(3):CD003054
references: 18646086
references: Diabetes Care. 2002 Dec;25(12):2165-71
references: 12453955
references: Diabetes Care. 2010 Sep;33(9):2077-83
references: 20573752
references: Curr Diab Rep. 2014 Jun;14(6):493
references: 24743942
references: Diabetes Care. 2014 Jan;37 Suppl 1:S14-80
references: 24357209
references: Circulation. 2009 Jan 27;119(3):e21-181
references: 19075105
references: BMJ. 1995 Jan 14;310(6972):83-8
references: 7833731
references: Lancet. 2011 Jul 2;378(9785):31-40
references: 21705069
references: Lancet. 2002 Jun 15;359(9323):2072-7
references: 12086760
references: N Engl J Med. 2008 Feb 7;358(6):580-91
references: 18256393
references: PLoS One. 2013;8(2):e57143
references: 23451166
references: Diabetes Care. 1999 Feb;22(2):233-40
references: 10333939
references: Diabetes Care. 2007 Jun;30(6):1374-83
references: 17363746
references: Diabetes Care. 1998 Mar;21(3):360-7
references: 9540016
references: N Engl J Med. 2009 Jan 8;360(2):129-39
references: 19092145
references: Cardiovasc Diabetol. 2014 Jun 30;13:104
references: 24981579
references: Arch Intern Med. 2003 Jun 23;163(12):1440-7
references: 12824093
references: Diabetes Obes Metab. 2012 Jul;14(7):616-25
references: 22284386
references: Diabetologia. 2009 Nov;52(11):2288-98
references: 19655124
references: BMJ. 2000 Aug 12;321(7258):412-9
references: 10938049
references: Diabetes Care. 2011 Jan;34 Suppl 1:S62-9
references: 21193628
references: Diabetes Care. 2000 Mar;23(3):278-82
references: 10868851
references: Diabetes Metab Res Rev. 2013 Jan;29(1):25-32
references: 22887834
references: Diabetologia. 2011 Feb;54(2):300-7
references: 21046360
references: Lancet. 2014 Mar 22;383(9922):1059-66
references: 24361242
references: BMJ. 2000 Aug 12;321(7258):405-12
references: 10938048
references: Diabetes Care. 2012 Jan;35 Suppl 1:S64-71
references: 22187472
references: Diabetes Res Clin Pract. 2006 May;72(2):117-27
references: 16297488
references: Arch Intern Med. 2011 Mar 14;171(5):404-10
references: 21403036
references: N Engl J Med. 2001 May 3;344(18):1343-50
references: 11333990
references: Diabetes Res Clin Pract. 2001 Apr;52(1):29-43
references: 11182214
references: BMJ. 1990 Sep 1;301(6749):397-402
references: 2282392
references: N Engl J Med. 2002 Feb 7;346(6):393-403
references: 11832527
references: Eur Heart J. 2005 Jul;26(14):1369-78
references: 15860521
references: Lancet. 2009 May 23;373(9677):1765-72
references: 19465231
references: Diabetes Care. 2009 Aug;32(8):1404-10
references: 19602539
references: Am J Cardiol. 2007 Jun 18;99(12A):21i-33i
references: 17599422
references: Int J Behav Nutr Phys Act. 2014 Jan 15;11:2
references: 24423095
references: Diabetes Care. 1993 Feb;16(2):434-44
references: 8432214
references: Ann Intern Med. 2009 Sep 15;151(6):394-403
references: 19620144
references: BMJ. 2011 Jul 26;343:d4169
references: 21791495
references: Arch Intern Med. 2012 Sep 24;172(17):1285-95
references: 22868663
references: Diabetologia. 2001 Sep;44 Suppl 2:S54-64
references: 11587051