Influence of life style factors in development of diabetes in Indians--scope for primary prevention.

ABSTRACT

OBJECTIVE: The objective of the study was to evaluate the influence of physical activity and stress factors on the development of diabetes mellitus (DM). METHODS: One hundred and eighty-seven adult subjects (MF 11275), registered in the primary prevention of diabetes programme for 2 or more years were studied prospectively. The study was done only in those who had either normal glucose tolerance (NGT) or diabetes at the time of review (tR). At entry (tE), 121 (64.7%) had normal glucose tolerance (NGT) and 66 (34.3%) had impaired glucose tolerance (IGT) by the WHO criteria. Dietary modifications and regular exercise programme were advised. Dietary modifications and regular exercise programme were advised. Study subjects were reviewed during August 1997 to October 1998. At review (TR) none had known history of diabetes. At TR, the status of glucose tolerance was assessed by oral GTT and influence of intervention measures and evaluation of the role of physical and psychological stress on glucose tolerance were assessed by a questionnaire method. RESULTS: At tR, 100 (53.5%) had NGT, and 87 (46.5%) had developed diabetes (DM). Adherence to exercise and other preventive measures was poor in the DM compared to nondiabetic group (NGT) (P < 0.0012). They showed lower dietary adherence (P = 0.042) and scores on mental stress was higher than in NGT group (P < 0.001). After controlling for age, gender and the initial 2 h plasma glucose, non-adherence to exercise and high scores of psychological stress showed strong association with diabetes. CONCLUSION: In this study, significant and independent roles of physical inactivity and psychological stress factors are demonstrated in the development of diabetes.