Relationship between baseline physical activity assessed by pedometer count and new-onset diabetes in the NAVIGATOR trial

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http://hdl.handle.net/10138/299730

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Kraus , W E , Yates , T , Tuomilehto , J , Sun , J-L , Thomas , L , Mcmurray , J J V , Bethel , M A & Holman , R R 2018 , ' Relationship between baseline physical activity assessed by pedometer count and new-onset diabetes in the NAVIGATOR trial ' , BMJ Open Diabetes Research & Care , vol. 6 , no. 1 , e000523 . https://doi.org/10.1136/bmjdrc-2018-000523

Title: Relationship between baseline physical activity assessed by pedometer count and new-onset diabetes in the NAVIGATOR trial
Author: Kraus, W.E.; Yates, T.; Tuomilehto, J.; Sun, J.-L.; Thomas, L.; Mcmurray, J.J.V.; Bethel, M.A.; Holman, R.R.
Contributor: University of Helsinki, Clinicum
Date: 2018
Language: eng
Belongs to series: BMJ Open Diabetes Research & Care
ISSN: 2052-4897
URI: http://hdl.handle.net/10138/299730
Abstract: Objective: Physical activity is related to clinical outcomes, even after adjusting for body mass, but is rarely assessed in randomized clinical trials. Research design and methods: We conducted an observational analysis of data from the Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research trial, in which a total of 9306 people from 40 countries with impaired glucose tolerance and either cardiovascular disease or cardiovascular risk factors were randomized to receive nateglinide or placebo, in a 2-by-2 factorial design with valsartan or placebo. All were asked to also participate in a detailed lifestyle modification programme and followed-up for a median of 6.4 years with progression to diabetes as a co-primary end point. Seven-day ambulatory activity was assessed at baseline using research-grade pedometers. We assessed whether the baseline amount of physical activity was related to subsequent development of diabetes in individuals with impaired glucose tolerance. Results: Pedometer data were obtained on 7118 participants and 35.0% developed diabetes. In an unadjusted analysis each 2000-step increment in the average number of daily steps, up to 10 000, was associated with a 5.5% lower risk of progression to diabetes (HR 0.95, 95%CI 0.92 to 0.97), with >6% relative risk reduction after adjustment. Conclusions: Physical activity should be measured objectively in pharmacologic trials as it is a significant but underappreciated contributor to diabetes outcomes. It should be a regular part of clinical practice as well. © 2018 Author(s) (or their employer(s).
Subject: nateglinide
placebo
valsartan, adult
aged
Article
body mass
cardiovascular disease
cardiovascular risk
clinical outcome
controlled study
diabetes mellitus
disease exacerbation
double blind procedure
female
follow up
human
impaired glucose tolerance
lifestyle modification
major clinical study
male
observational study
physical activity
randomized controlled trial
risk reduction
3141 Health care science
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