Increased physical activity may reduce the incidence of type 2 diabetes mellitus irrespective of genetic risk

1. In this prospective cohort study, it was found that those with the highest levels of moderate-to-vigorous physical activity (MVPA) had the lowest risk of incident type 2 diabetes (T2DM), independent of genetic risk.

2. However, there was an additive interaction between MVPA and genetic risk, suggesting a greater effect of MVPA among those at a higher genetic risk for T2DM.

Evidence Rating Level: 2 (Good)

Physical activity remains a mainstay in the treatment of type 2 diabetes mellitus (T2DM). However, such recommendations have been founded mainly on self-reported measurements. Many patients may also be at higher genetic risk for developing T2DM, and the modification of this risk through exercise has not been studied. As a result, the objective of the present prospective cohort study was to examine the dose-response relationship between total and intensity-specific physical activity and incident T2DM while also accounting for genetic risk.

The present study recruited 59,325 (mean age=61.1, 44% male) patients without diabetes from 2013 to 2015. Patients were excluded if they had a diagnosis of diabetes, cardiovascular disease, or cancer before measurement with an accelerometer. The physical activity data were obtained using an accelerometer. Genetic risk was estimated using a polygenic risk score (PRS). Statistical analyses were performed using multivariable Cox proportional hazards models for incident T2DM according to categories of physical activity. The primary outcome was incident T2DM.

The results demonstrated that over a median follow-up of 6.8 years, there were 884 incident T2DM cases. Participants in the most active group had an 80% lower risk of incident T2DM than those who were the least active, independent of genetic risk. However, participants with a genetic risk for T2DM had the most significant absolute risk reduction for T2DM associated with MVPA. Despite these results, the study was limited by the lack of longitudinal patterns of physical activity, which may have limited evaluation of its long-term benefits. However, the present study has been the largest accelerometer-based dataset that found an association between physical activity levels and incident T2DM.

Click to read the study in British Journal of Sports Medicine

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