Physical Activity and Improvement of Glycemia in Prediabetes by Different Diagnostic Criteria

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 β-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.

Prospective association between late evening food consumption and risk of prediabetes and diabetes: the Whitehall II cohort study

“…We observed an association between TLEE and prediabetes/diabetes development among women with a good glycaemic control. Differences in food patterns between men and women are common , and we have previously observed sex‐specific associations between lifestyle factors and glucose regulation in the Whitehall II cohort , supporting these findings. Whether late evening food consumption disturbs circadian rhythm differently in men and women needs further investigation.…”

Pathophysiological Characteristics Underlying Different Glucose Response Curves: A Latent Class Trajectory Analysis From the Prospective EGIR-RISC Study

“…However, a recent study showed that HbA 1c may not be able to capture the pathophysiological diversity of impaired fasting glycemia (IFG) and impaired glucose tolerance (IGT) (2). Also, individuals identified as having prediabetes on the basis of the HbA 1c criterion seem to have a different response to physical activity and lower probability of reverting to normoglycemia than those identified through the use of the glucose criteria (3). Thus, understanding the pathophysiological differences between subgroups of individuals with prediabetes is crucial to stratify risk and to facilitate more targeted prevention-focused interventions.…”

“…Adjusted for age, sex, smoking status, physical activity, and alcohol consumption 3. Adjusted for age, sex, smoking status, physical activity, alcohol consumption, and BMI.…”

Lifestyle factors and reversion to normoglycaemia by prediabetes type in PREDAPS study.

“…Despite there are prior studies evaluating the proportion of reversion to normoglycaemia, all them were heterogeneous in design, duration of follow-up and criteria definition yielding a broad range of reversion rates [15][16][17][18][19], and only few did it according to prediabetes status criteria [10,20]. The latter, a Japanese study [20] using four prediabetes subgroups according to elevated HbA1c and/or IFG, observed a greater proportion of reversion rates among those with elevated HbA1c levels.…”

“…For example, some studies have found a better response to glucose regulation after applying lifestyle modifications only in individuals with IGT [9]. In addition, a recent study observed how individuals with HbA1c levels in range of prediabetes were less likely to revert to normal glycaemia after physical activity recommendations [10].…”