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Article Title

Assessing the Association Between Exercise Status and Poor Glycemic Control

Publication Date

8-10-2017

Keywords

observational studies, diabetes, chronic disease

Abstract

Background: Increased physical activity may be associated with greater glycemic control among adults with diabetes mellitus. However, the area is understudied. The objective of the study was to examine the independent association of exercise status with poor glycemic control, adjusting for patient-level covariates.

Methods: We studied a population of Kaiser Permanente Northwest members with type 2 diabetes mellitus who were in: 1) good glycemic control (hemoglobin A1c [HbA1c] < 8%; n = 15,891), or 2) poor glycemic control (HbA1c > 9%; n = 3,709). Additional inclusion criteria included an HbA1c test between July 1, 2014, and June 30, 2015, age 18-plus at time of test, and continuous health plan coverage 12 months prior to HbA1c test. The primary independent was current physical activity status — whether an individual exercised 4 or more times per week (yes vs no) — and was assessed as closely as possible to the HbA1c test date. Multiple logistic regression was used to analyze the independent association of exercise status with poor glycemic control, adjusting for demographics, medication adherence, medical comorbidities, health care utilization, receipt of diabetes mellitus care management services and intensity of diabetes mellitus treatments.

Results: Those who exercised 4 or more times per week were less likely to have poor glycemic control (odds ratio: 0.75; 95% confidence interval: 0.68–0.82; P < 0.0001) compared with those who exercised 3 or fewer times per week.

Conclusion: Increased exercise is independently associated with a lower likelihood of poor glycemic control among an adult population with type 2 diabetes mellitus. Because physical activity is a potentially modifiable factor, further studies are needed to evaluate whether interventions aimed at increasing physical activity result in subsequent gains in glycemic control.

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