Physical activity and improvement of glycemia in prediabetes by different diagnostic criteria

Kristine Færch, Daniel Rinse Witte, Eric John Brunner, Mika Kivimäki, Adam Tabák, Marit Eika Jørgensen, Ulf Ekelund, Dorte Vistisen

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Abstract

Context: The effects of physical activity (PA) on improvement of glycemia may differ between prediabetic individuals defined by oral glucose tolerance test vs glycated hemoglobin (HbA1c). Objective: We studied the association between PA and improvement of glycemia in individuals with prediabetes defined by glucose vs HbA1c criteria. Design, Setting, and Participants: From the Whitehall II study, 957 participants with prediabetes defined by isolated impaired fasting glucose (i-IFG), isolated impaired glucose tolerance (i-IGT), or both and 457 with prediabetes defined by HbA1c were included. Main Outcome Measures: The associations of PA with concomitant changes in glucose-related outcomes during 5 years of follow-up were analyzed. A recursive partitioning analysis was performed to study heterogeneity in the association between baseline PA and the probability of reversion to normoglycemia. Results: After 5 years of follow-up, 405 (42%) individuals with glucose-defined prediabetes reverted to normal glucose tolerance (NGT). A 5-year increase in moderate-to-vigorous-intensity PA was associated with improvements in insulin sensitivity and b-cell function, but PA was not generally associated with reversion to NGT. Only among women $50 years with i-IFG or i-IGT, higher amounts of PA were associated with higher probability of reversion to NGT. In HbA1c-defined prediabetes, only 20 individuals (4.4%) reverted to normoglycemia, and PA was not associated with improvement in glycemic markers. Conclusions: PA may be particularly important for reversion to normoglycemia among older women with i-IFG or i-IGT. Individuals with prediabetes identified by HbA1c have a low probability of reversion to normoglycemia, and their changes in glycemia are not related to PA.

Original languageEnglish
Pages (from-to)3712-3721
Number of pages10
JournalJournal of Clinical Endocrinology and Metabolism
Volume102
Issue number10
DOIs
Publication statusPublished - Oct 2017

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ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical

Cite this

Færch, K., Witte, D. R., Brunner, E. J., Kivimäki, M., Tabák, A., Jørgensen, M. E., Ekelund, U., & Vistisen, D. (2017). Physical activity and improvement of glycemia in prediabetes by different diagnostic criteria. Journal of Clinical Endocrinology and Metabolism, 102(10), 3712-3721. https://doi.org/10.1210/jc.2017-00990