Prospective study of risk factors for development of non-insulin dependent diabetes in middle aged British men

Abstract

Objective-To determine the risk factors for noninsulin dependent diabetes in a cohort representative ofmiddle aged British men.Design-Prospective study. Subjects and setting-7735 men aged 40-59, drawn from one group practice in each of 24 towns in Britain. Known and probable cases of diabetes at screening (n= 158) were excluded.Main outcome measures-Non-insulin dependent diabetes (doctor diagnosed) over a mean follow up period of 12 8 years.Results-There were 194 new cases of non-insulin dependent diabetes. Body mass index was the dominant risk factor for diabetes, with an age adjusted relative risk (upper fifth to lower fifth) of 11-6; 95% confidence interval 5*4 to 16-8. Men engaged in moderate levels of physical activity had a substantially reduced risk of diabetes, relative to the physically inactive men, after adjustment for age and body mass index (0.4; 0*2 to 0.7), an association which persisted in full multivariate analysis. A nonlinear relation between alcohol intake and diabetes was observed, with the lowest risk among moderate drinkers (16-42 units/week) relative to the baseline group of occasional drinkers (0.6; 0 4 to 1.0). Additional significant predictors of diabetes in multivariate analysis included serum triglyceride concentration, high density lipoprotein cholesterol concentration (inverse association), heart rate, uric acid concentration, and prevalent coronary heart disease.Conclusion-These findings emphasise the interrelations between risk factors for non-insulin dependent diabetes and coronary heart disease and the potential value of an integrated approach to the prevention of these conditions based on the prevention of obesity and the promotion of physical activity.

Leisure time physical activity and the risk of type 2 diabetes in men and women from the general population

“…Further results from the Nurses Health Study suggested that, independently of exercise levels, sedentary behaviours, especially TV watching, were associated with significantly elevated risk of type 2 diabetes and obesity, whereas even light to moderate activities were associated with a substantially lower risk [24]. Also, an inverse association between exercise and incidence of type 2 diabetes was observed among residents of the UK [21,25] and Finland [13,26]. The findings in the present study extend the literature showing that leisure time physical activity is associated with a reduction in risk of type 2 diabetes.…”

Knowledge, self-help and socioeconomic factors in South Asian and Caucasian diabetic patients

“…Undoubtedly, various issues interlink with each other in a complicated and, at present, rather undetermined manner, to produce an overall picture of lower awareness and self-help in the South Asian population. Although genetic effects may play a role in the higher prevalence of diabetes in the Asian population, 25 lifestyle issues such as exercise are also very important 26,27 and sedentary lifestyles may place Asians in the high-risk category. 28,29 Although information to promote increased physical activity and control obesity has been promoted by health information systems, this study highlights a lack of understanding of these important issues in Asians.…”

Non classical risk factors for gestational diabetes mellitus: a systematic review of the literature

“…Although cigarette smoking is positively associated with hyperinsulinism and insulin resistance in some studies 39,40 , the association between tobacco and gestational diabetes mellitus has been little investigated. A cross-sectional study carried out in Scandinavia 41 showed that to smoke more than ten cigarettes per day during pregnancy affects the homeostasis of the glucose towards gestational diabetes mellitus, which was confirmed by others 42 .…”