Abstract
Aims: Epidemiologic evidence suggests that physical activity is associated with reduced risk of Type 2 diabetes. Walking is simple, effective, and by far the most prevalent physical activity among older adults. However, it is difficult to recognize and evaluate performance-based parameters of physical activity. The purpose of this study was to evaluate the importance of performance-based gait speed among several physical measurements in the development of Type 2 diabetes using long-term community-based data on elderly Japanese persons. Methods: 10 baseline physical measurements, including habitual (HGS) and fast (FGS) gait speed, were examined in 102 elderly Japanese persons living independently in the community (mean age: 71.1 years old) who were not previously diagnosed with diabetes. The subjects then participated in a daily exercise program consisting of walking, stretching, muscle strengthening, and balance exercises and were followed for an average of 4.16 years. Using Cox proportional hazards models with adjustment for age, sex, and category of fasting glucose status, we investigated whether gait speed and/or other physical measurements are associated with development of Type 2 diabetes. Results: 9 subjects developed Type 2 diabetes. Among the 10 physical parameters examined, prolongation of HGS and FGS per second was the only statistically significant factors, with hazard ratios 1.83 (1.15 - 2.89, P = 0.010) and 2.93 (1.43 - 6.03, P = 0.003), respectively. Conclusions: We found a negative association between the development of Type 2 diabetes and gait speed among elderly Japanese people. We conclude that encouraging physical activity and preserving walking capacity may be beneficial for preventing Type 2 diabetes.
Highlights
Type 2 diabetes mellitus is a growing public health concern worldwide, with the number of people developing the condition increasing rapidly [1]
Among the 10 measured physical parameters, only HGS and FGS were significantly related to development of Type 2 diabetes after adjustment for age, sex, and fasting glucose status, with hazard ratios 1.83 (1.15 - 2.89, P = 0.010) and 2.93 (1.43 - 6.03, P = 0.003), respectively (Table 2)
Among community-dwelling elderly subjects without diabetes, there was an inverse association between development of Type 2 diabetes and gait speed that was independent of age, sex, and fasting glucose status
Summary
Type 2 diabetes mellitus is a growing public health concern worldwide, with the number of people developing the condition increasing rapidly [1]. In a large cohort study, Hu et al found a strong association between walking pace assessed by questionnaire and risk of Type 2 diabetes even after adjustment for several known confounders [5]. It is not often in a clinical setting that measurement takes place of performance-based parameters of physical activity, such as gait speed. There exist several methods other than gait speed for evaluating physical activity, studies examining the association between development of Type 2 diabetes and performance-based parameters of physical activity are relatively sparse
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