Coffee consumption and incidence of impaired fasting glucose,impaired glucose tolerance,and type 2 diabetes: the Hoorn Study

Aims/hypothesis Coffee contains several substances that may affect glucose metabolism. The aim of this study was to evaluate the relationship between habitual coffee consumption and the incidence of IFG, IGT and type 2 diabetes.Methods We used cross-sectional and prospective data from the population-based Hoorn Study, which included Dutch men and women aged 50–74 years. An OGTT was performed at baseline and after a mean follow-up period of 6.4 years. Associations were adjusted for potential confounders including BMI, cigarette smoking, physical activity, alcohol consumption and dietary factors.Results At baseline, a 5 cup per day higher coffee consumption was significantly associated with lower fasting insulin concentrations (–5.6%, 95% CI –9.3 to –1.6%) and 2-h glucose concentrations (–8.8%, 95% CI –11.8 to –5.6%), but was not associated with lower fasting glucose concentrations (–0.8%, 95% CI –2.1 to 0.6%). In the prospective analyses, the odds ratio (OR) for IGT was 0.59 (95% CI 0.36–0.97) for 3–4 cups per day, 0.46 (95% CI 0.26–0.81) for 5–6 cups per day, and 0.37 (95% CI 0.16–0.84) for 7 or more cups per day, as compared with the corresponding values for the consumption of 2 or fewer cups of coffee per day (p=0.001 for trend). Higher coffee consumption also tended to be associated with a lower incidence of type 2 diabetes (OR 0.69, CI 0.31–1.51 for 7 vs 2 cups per day, p=0.09 for trend), but was not associated with the incidence of IFG (OR 1.35, CI 0.80–2.27 for 7 vs 2 cups per day, p=0.49 for trend).Conclusions/interpretation Our findings indicate that habitual coffee consumption can reduce the risk of IGT, and affects post-load rather than fasting glucose metabolism.     

硫化氢对老年空腹血糖调节受损和2型糖尿病的影响

目的 通过检测老年空腹血糖调节受损（IFG）和2型糖尿病患者的血清硫化氢（H2S）水平,探讨气体分子H2S在老年空腹血糖调节受损和2型糖尿病中的临床意义.方法 2型糖尿病患者66例,空腹血糖调节受损患者36例,正常对照组33例,检测入选者的血清H2S浓度.结果 与对照组相比,空腹血糖调节受损患者和2型糖尿病患者HOMA-IR指数明显升高[（3.24±0.93）、（2.34±1.12）比（1.70±1.10）,P＜0.05]、HOMA-β指数降低[（76.41±26.20）、（36.13±23.37）比（93.00±40.46）,P＜0.05],血清H2S水平明显升高[（60.93±12.95）、（63.64±10.96）比（50.07±10.85） μmol/L,P＜0.05].Pearson相关分析结果显示,H2S浓度与空腹血糖调节受损组和糖尿病组患者HOMA-β均呈显著负相关（γ值分别为-0.65、-0.69,P＜0.05）,与HOMA-IR均呈显著正相关（γ值分别为0.73、0.76,P＜0.05）.结论 内源性H2S可能通过抑制β细胞功能和增强胰岛素抵抗参与空腹血糖调节受损和2型糖尿病的发病过程.     

High incidence of type 2 diabetes and increasing conversion rates from impaired fasting glucose and impaired glucose tolerance to diabetes in Mauritius

OBJECTIVE: To describe the incidence of different stages of glucose intolerance in a population from Mauritius followed over 11 years. RESEARCH DESIGN, METHODS AND SUBJECTS: Population-based surveys were undertaken in the multi-ethnic nation of Mauritius in 1987, 1992 and 1998 with 5083, 6616 and 6291 participants, respectively. Questionnaires, anthropometric measurements, and a 2-h 75-g oral glucose tolerance test were included. Three cohorts aged between 25 and 79 years with classifiable glucose tolerance data were identified; 3680 between 1987 and 1992, 4178 between 1992 and 1998, and 2631 between 1987 and 1998. Glucose tolerance was classified according to WHO 1999 criteria. RESULTS: The incidence rate of type 2 diabetes was higher between 1992 and 1998 than between 1987 and 1992. In men, the incidence was similar between cohorts (24.5 and 25.4 per 1000 person-years) whereas the incidence increased in women (23.3 and 16.4 per 1000 person-years). The incidence of diabetes peaked in the 45-54 year age group and then plateaued or fell. The incidences of impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) decreased in both men and women. Of normoglycaemic subjects at baseline, more women than men developed IGT and more men than women developed IFG. Of those labelled as IFG in 1987, 38% developed diabetes after 11 years. The corresponding figure for IGT was 46%. CONCLUSIONS: In this study, we report changes in incidence rates of glucose intolerance over a 11-year period. In particular, differences between men and women were observed. The increased incidence of IGT in women compared with men, and increased incidence of IFG in men compared with women was consistent with, and explains the sex biases seen in the prevalences of these states.     

Optimizing blood glucose control in type 2 diabetes: an approach based on fasting blood glucose measurements

A structured approach to the management of Type 2 diabetes, aiming to reduce fasting blood glucose levels to near-normal, can provide effective blood glucose control with minimal risk of hypoglycaemia and in a manner acceptable to most patients. When the fasting blood glucose value is maintained in the region 4-6 mmol l-1, protein glycosylation and plasma triglyceride values usually become near-normal and this may help to prevent the development of long-term diabetic complications. We propose a simple management strategy, based on 3-monthly fasting blood glucose determination, which uses not more than two therapeutic agents at any one time. If diet and maximal oral therapy fail to keep fasting blood glucose levels below 6 mmol l-1 then the addition of a basal insulin supplement, e.g. from a once daily injection of ultralente insulin, can restore near-normal fasting blood glucose levels without the need for full insulin replacement therapy. In older patients, where long-term prevention of diabetic complications is not such an immediate priority, less strict blood glucose control may be reasonable, aiming to keep the fasting blood glucose values below 10 mmol l-1 in order to prevent symptoms secondary to glycosuria. Patients can be seen at a monthly general practice morning diabetic mini-clinic or with the aid of a nurse visiting elderly patients at home.     

Serum gamma-glutamyltransferase and development of impaired fasting glucose or type 2 diabetes in middle-aged Japanese men

OBJECTIVE: To investigate the association between serum gamma-glutamyltransferase (GGT) and risk for development of diabetes. DESIGN: Longitudinal study (followed from 1994 to 2001). SETTING: A work site in Japan. SUBJECTS: A total of 2918 Japanese male office workers aged 35-59 years who did not have impaired fasting glucose (IFG) (a fasting plasma glucose concentration of 6.1-6.9 mmol L-1), type 2 diabetes (a fasting plasma glucose concentration of >/=7.0 mmol L-1 or receipt of hypoglycaemic medication), medication for hypertension or hepatitis, alanine aminotransferase concentrations higher than three times the upper limit of the reference range or a history of cardiovascular disease at study entry. MAIN OUTCOME MEASURE: Incidence of IFG or type 2 diabetes over a 7-year period. RESULTS: With adjustment for potential risk factors for diabetes, the relative risk for IFG compared with serum GGT <16 U L-1 was 1.23 (95% CI, 0.79-1.90), 1.50 (CI, 0.97-2.32) and 1.70 (CI, 1.07-2.71) with serum GGT of 16-24, 25-43 and >/=44 U L-1, respectively (P for trend = 0.014). The respective relative risks for type 2 diabetes compared with serum GGT <16 U L-1 were 2.54 (CI, 1.29-5.01), 2.64 (CI, 1.33-5.23) and 3.44 (CI, 1.69-6.70) (P for trend = 0.002). From stratified analyses by body mass index (BMI) and alcohol intake, a stronger linear association between serum GGT and development of IFG or type 2 diabetes was found in men with a BMI >/=23.2 kg m-2 in both those who drank <46 and >/=46 g day-1 of ethanol. CONCLUSIONS: The risk for development of IFG or type 2 diabetes increased in a dose-dependent manner as serum GGT increased in middle-aged Japanese men. The increased relative risk for IFG or type 2 diabetes associated with serum GGT was more pronounced in obese men.     

Incidence of Type 2 diabetes in England and its association with baseline impaired fasting glucose: the Ely study 1990-2000.

AIM: To determine the incidence of Type 2 diabetes and to examine the effect of different cut-points for impaired fasting glucose (IFG) on diabetes incidence. METHODS: Population-based longitudinal study (1990-2000) with clinical, anthropometric and biochemical measurements, including an oral glucose tolerance test (OGTT), in 1040 non-diabetic adults aged 40-69 years at baseline. Baseline glucose status was defined as normoglycaemia < 5.6, IFG-lower 5.6-6.0 and IFG-original 6.1-6.9 mmol/l. The all-IFG group included fasting glucose values of 5.6-6.9 mmol/l. RESULTS: The 10-year cumulative incidence of diabetes was 7.3 per 1000 person-years. Diabetes incidence was 2.4 [95% confidence interval (CI) 1.2, 4.8], 6.2 (4.0, 9.8) and 17.5 (12.5, 24.5) per 1000 person-years in those with normoglycaemia, IFG-lower and IFG-original, respectively. Compared with normoglycaemia, the age/sex-adjusted risk [hazard ratio (HR) and 95% CI] for incident diabetes was greatest in the IFG-original category (HR 6.9; 3.1, 15.2) and increased to a lesser degree in the IFG-lower (HR 2.5; 1.1, 5.7) and all-IFG categories (HR 4.1; 1.9, 8.7). When adjusted for confounding factors, the magnitude and direction of associations persisted, with HR 1.9, 4.4 and 2.9, for the categories IFG-lower, IFG-original and all-IFG, respectively. CONCLUSIONS: Diabetes incidence is more strongly related to IFG defined as fasting glucose between 6.1 and 6.9 mmol/l than to the lower category of 5.6-6.0 mmol/l, or entire range of 5.6-6.9 mmol/l. Future studies should examine the association of IFG with cardiovascular outcomes, but for diabetes risk our study supports the use of the IFG cut-point at 6.1 mmol/l.     

Long-term predictors of impaired fasting glucose and type 2 diabetes in subjects with family history of type 2 diabetes: A 12-years follow-up of the Brisighella Heart Study historical cohort

AimTo identify and quantify the role of different risk factors in the long-term development of IFG and T2DM in a rural Italian population sample with family history of T2DM.MethodsWe selected a sample of 1271 adult subjects from among those 1851 consecutively visited during four consecutive Brisighella Heart Study surveys (1996–2008), then selecting those ones with a family history of T2DM. Thus, we obtained a final sample including 545 subjects and for which a full clinical and ematochemistry data set was available.ResultsThe Cox-regression model better predicting the incident IFG and T2DM included age, gender, FPG, TG and SUA. The model best predicting the incident IFG status alone (without T2DM) is very similar to that predicting both IFG and T2DM, including the same predictors. Finally, the model best predicting T2DM (excluding IFG) simply includes FPG, BMI and ALT/AST ratio. Repeating the Cox-regression analysis using BMI as a covariate, TG appears to be also a significant predictor of T2DM (HR 1.018 95% CI 1.009–1.041, p = 0.013).ConclusionIn a sample of subjects with a family history of diabetes the best long-term predictors of IFG are age, gender, FPG, TG and SUA, while those of T2DM are FPG and BMI.     

Suppression of insulin secretion by falling plasma glucose levels is impaired in type 2 diabetes

The ability of Type 2 diabetic patients to suppress islet B-cell secretion in response to falling plasma glucose levels has been studied with two different protocols. (1) Five diet-treated diabetic patients and 6 normal subjects were studied after the termination of a hyperglycaemic clamp at 15 mmol l-1 for 150 min, with the plasma glucose levels then being allowed to fall and the glucose clamp re-established at 10 mmol l-1. The plasma insulin levels fell in normal subjects from 178 +/- 141 (+/- SD) mU l-1 at the end of the 15 mmol l-1 clamp to 147 +/- 97 mU l-1 (p less than 0.02) 20 min later, whereas in diabetic patients there was no significant change from 61 +/- 41 to 56 +/- 35 mU l-1, respectively (NS). (2) The second study was performed to assess the turn-off of islet B-cell secretion with diabetic patients and normal subjects starting at comparable plasma insulin levels. Twelve diet-treated diabetic patients and 11 normal subjects were given a continuous low-dose glucose infusion for 60 min at a rate of 5 mg kg-1 ideal body weight min-1, after which the infusion was turned off and the plasma glucose level allowed to fall.(ABSTRACT TRUNCATED AT 250 WORDS)     

二甲双胍和食物纤维在糖耐量低减人群向2型糖尿病发展中的干预作用

目的　观察二甲双胍和食物纤维预防糖耐量低减 (IGT)人群进展为 2型糖尿病 (DM)的作用。　方法　以口服 75 g葡萄糖耐量试验 (OGTT)确诊 (WHO标准 )的 IGT2 93例中男 2 16例 ,女 77例。入选者年龄 35岁以上 ,体重指数 (BMI)在 19kg/ m2以上。随机分为对照组 72例 ,教育组 5 7例 ,食物纤维组 84例 ,二甲双胍组 80例。对照组进行一般的健康教育 ;教育组进行饮食指导 ,每半年1次 ;食物纤维组除健康教育外 ,每日口服食物纤维 12 g;二甲双胍组每日口服二甲双胍 0 .75 g,分 3次餐后口服。对四组参试者每半年作 1次 OGTT,同时测身高、体重、BMI、12 h尿白蛋白 ,复查日当天不服干预药物或食物纤维。共观察 3年。若 2次 OGTT或最后 1次复查结果为 DM,则判断为已发展为 DM。　结果　 2 93例 IGT在观察中有 2 3例 (7.8% )退出。空腹血糖 (FBS)和服糖后 1h血糖 (1hPBS)在对照组、教育组和食物纤维组均较治疗前略有升高 ,但在二甲双胍治疗组均有下降。四组间FBS比较 F=8.118,P<0 .0 1,四组间 1h PBS比较 F=3.6 97,P=0 .0 12。观察期末对照组 16例 (2 5 .0 % )、教育组 11例 (2 1.6 % )、食物纤维组 13例 (16 .3% )、二甲双胍组 7例 (9.3% )转化为 DM,二甲双胍组在治疗后 DM转化率明显低于对照组 (χ2 =6 .318,P<0 .0     

The association between gender-related characteristics and type 2 diabetes risk in a multi-ethnic population: The HELIUS study

Background and aimsMen and women have different type 2 diabetes mellitus (T2DM) risks, which have been reported across populations of different ethnicity. Where differences in T2DM risk for sex (biological) have been studied, research on gender (socio-cultural) and T2DM risk is lacking. We explored, in a multi-ethnic population, the association of six gender-related characteristics with incident T2DM over 3 years, and the mediation by known risk factors for T2DM.Methods and resultsWe included 9605 women and 7080 men of the multi-ethnic HELIUS study (Amsterdam, the Netherlands). We studied associations between gender-related characteristics and incident T2DM, using Cox regression. After a median of 3.0 years (IQR 2.0; 4.0), 198 (2.1%) women and 137 (1.9%) men developed T2DM. A lower T2DM risk was observed in those not being the primary earner (HR 0.67; 95% CI 0.47; 0.93) and a higher desired level of social support (HR 0.62; 95% CI 0.44; 0.87). Hours spent on household work, home repairs, type of employment and male- or female-dominated occupation were not associated with T2DM incidence. No evidence for effect modification by biological sex or ethnicity was found. Known risk factors of T2DM did not mediate the observed associations.ConclusionGender-related characteristics, not being the primary earner and a higher desired social support were associated with reduced T2DM risk, and this was not mediated by known risk factors for T2DM.     

Nateglinide and acarbose for postprandial glucose control after optimizing fasting glucose with insulin glargine in patients with type 2 diabetes

Aims

Basal insulin treatment is frequently used in type 2 diabetes, but the successful control of postprandial glucose is challenging. We compared the effect of preferential postprandial glucose targeting drugs for postprandial glucose control after optimizing fasting glucose with basal insulin.

Methods

This study was performed in 58, insulin naïve type 2 diabetes. After fasting glucose was optimized by insulin glargine, nateglinide or acarbose was initiated and then crossed over after second wash out period. 75 g oral glucose tolerance test and 7 point self monitoring blood glucose for 3days at the end of each period was performed.

Results

Both drugs effectively reduced postprandial glucose levels compared with the insulin glargine monotherapy. No significant differences were found between nateglinide and acarbose in terms of mean glucose level, standard deviation of glucose levels, mean average glucose excursion and average daily risk range. Homeostasis model analysis (HOMA)% β, corrected insulin response and insulin-to-glucose ratio were significantly higher in the responder group compared with the non-responder. There was no episode of severe hypoglycemia.

Conclusions

Nateglinide and acarbose are equally effective in type 2 diabetes for postprandial glucose excursions during basal insulin treatment. The markers of beta cell function might be used for predicting response. (Clinical trial reg. no. NCT 00437918, clinicaltrail.gov.)     

糖代谢异常和糖尿病患者脉压的研究

目的:脉压与心脑血管疾病相关,糖代谢异常和2型糖尿病也是心脑血管疾病的危险因子,但是脉压与糖代谢异常、2型糖尿病的关系未见在我国人群中的研究报道。方法:对2 420例常规健康体检者进行血浆总胆固醇、甘油三酯、收缩压、舒张压、脉压和体重指数(BMI)测定,观察脉压与糖代谢异常和2型糖尿病的关系。为了避免年龄对脉压的影响,我们将所有被检查者以年龄分为3组(40~54岁组、55~69岁组和≥70岁组)。结果:40~54岁者脉压、收缩压、舒张压、BMI和甘油三酯在糖代谢异常和2型糖尿病组明显升高(P<0.01),总胆固醇在各组之间差异无显著性(P>0.05)。55~69岁者只有脉压在糖代谢异常和2型糖尿病组中明显升高(P<0.05)。年龄≥70岁组中,所有观察指标在各组之间差异均无显著性(P>0.05)。结论:脉压在年龄<70岁的糖代谢异常和2型糖尿病患者中升高。脉压升高预示着心脑血管疾病危险因素的存在。     

Incidence of impaired glucose regulation and progression to type 2 diabetes mellitus in the Tayside region of Scotland

This study assessed incidence of impaired glucose regulation (IGR) and progression to type 2 diabetes (T2D) in adults in one region of Scotland using routinely collected health-care data. Incidence of IGR was 2720 per 100,000 person years. Nine percent of IGR patients progressed to T2D in a mean time of 34 months.     

The threshold for definition of impaired fasting glucose in a Japanese population

Aims We examined whether the cut‐off value of fasting plasma glucose (FPG) for diagnosing impaired fasting glucose (IFG) should be lowered, using data from a large Japanese population. Methods A retrospective cohort study was conducted from 1998 to 2006. Follow‐up (2002–2006) data were merged with baseline (1998–2002) data, yielding 11 129 persons who had participated on both occasions. Among these, 10 475 persons who did not have diabetes (known diabetes or defined as FPG ≥ 7.0 mmol/l) or suspected diabetes (glycated haemoglobin ≥ 6.4%) were analysed. Results During follow‐up of an average of 5.4 years, 279 (5.2%) out of 5372 men and 98 (1.9%) out of 5103 women developed diabetes. According to the three baseline FPG categories (< 5.6, 5.6–6.1 and 6.2–6.9 mmol/l), 28/3401 (0.8%), 91/1456 (6.3%) and 160/515 (31.1%), respectively, in men and 13/4231 (0.3%), 30/695 (4.3%) and 55/177 (31.1%), respectively, in women developed diabetes. The optimal cut‐off FPG value to predict diabetes was 5.7 mmol/l for both men (sensitivity 84.2%, specificity 76.9%) and women (81.6%, 91.0%). However, lowering the cut‐off from 6.1 to 5.7 mmol/l increased the prevalence of IFG 2.7‐fold in men and 3.0‐fold in women. Lowering the value further to 5.6 mmol/l increased the prevalence of IFG 3.8‐fold in men and 4.9‐fold in women. Conclusions It may be reasonable to retain the conventional lower FPG limit for IFG and treat FPG values of 5.6–6.1 mmol/l as non‐diabetic hyperglycaemia, considering the four‐ to fivefold increase in individuals classified as IFG when the new cut‐off is applied.     

Variability of fasting plasma glucose and the risk of painful diabetic peripheral neuropathy in patients with type 2 diabetes

Aim

The relationship between glycaemic variability and painful diabetic peripheral neuropathy (PDPN) in patients with type 2 diabetes (T2D) is unclear. The aim of this study was to investigate whether variations in fasting plasma glucose (FPG), as represented by the coefficient of variation (CV), were associated with the risk of PDPN in patients with T2D.

Associations between obesity indices and both type 2 diabetes and impaired fasting glucose among West African adults: Results from WHO STEPS surveys

Background and aimVarious obesity indices such as BMI, waist circumference (WC), waist-hip ratio, (WHR) and waist-to-height ratio (WHtR) are associated with the risk of type 2 Diabetes Mellitus (T2DM). Given few studies examining the strength of the association in this population, we aimed to identify which obesity indices are most strongly associated with T2DM and impaired fasting glucose (IFG) among adults from five West African countries.Methods and resultsData from 15,520 participants from the World Health Organisation (WHO) STEPs surveys in Burkina Faso, Benin, Mali, Liberia, and Ghana were included in analyses. Multinomial logistic regression was used to calculate the relative risk (RR) per standard deviation (SD) of each anthropometric measure, modelled as both continuous variables and as categorical variables based on established cut-points. In the analyses with continuous variables, the unadjusted RRs for T2DM per SD were 1.30 (1.23, 1.37) for body mass index (BMI); 1.56 (1.46, 1.67) for WC; 2.57 (2.15, 3.09) for WHtR and 1.16 (1.03, 1.31) for WHR. WHtR showed the strongest association with T2DM in all adjusted analyses. For models using categorical variables based on established cut-points, obesity defined using waist circumference (OB-WC) and OB-BMI showed the strongest associations with T2DM, and OB-WHR, the weakest association in all adjusted analyses.ConclusionWHtR and WC appear to be the indices most strongly associated with T2DM and IFG respectively. Given its simplicity, WC may be the metric that most usefully conveys risk for T2DM in West African adults.     

2型糖尿病大鼠胰腺微区血液灌流量与空腹血糖的相关性研究

Objective To observe the dynamic change of microcirculatory hemoperfusion in pancreatic head,body and tail of type 2 diabetic rats and its relationship with fasting blood glucose.Method All Wistar rats were randomly divided into control group(n=130)and experimental group(n=150).The rat model of type 2 diabetes mellitus was established by high-fat,high-sugar feeding combined with low-dose streptozotocin(30 mg/kg).At the 0,4,8,12,16 weeks after the occurrence of diabetes,twenty rats were picked up randomly and respectively from two groups,and microcirculatory hemoperfusion in pancreatic head,body and tail and fasting blood slucose were measured in vivo.Results At the 0,4,8,12,16 weeks after the occurrence of diabetes,fasting blood glucose in experimental group were(10.25±7.98),(14.72±7.51),(19.23±6.09),(22.44±7.45),(26.03±4.96)mmol/L respectively,while microcirculatory hemoperfusion in pancreatic body and tail were(2.46±0.90),(2.79±1.34),(3.15 ±1.24),(3.76±0.99),(4.28±0.23)V respectively.They both increased progressively(P<0.05).No significant changes were found in pancreatic head compared with control group(P>0.05). Microcirculatory hemoperfusion in pancreatic body and tail was positively associated with fasting blood glucose(r=0.3786,P<0.05).Conclusion Microcirculatory hemoperfusion in pancreatic body and tail increased with the increase of fasting blood glu cose in type 2 diabetic rats.     

Daily life activity and risk of developing impaired fasting glucose or Type 2 diabetes in middle-aged Japanese men

Aims/hypothesis The aim of this study was to investigate the association between daily life activity and risk of developing diabetes.Methods The study population included 2924 Japanese male office workers aged 35 to 59 years who did not have IFG (fasting plasma glucose level 6.1–6.9 mmol/l), Type 2 diabetes (fasting plasma glucose level 7.0 mmol/l and/or medication for diabetes) or a history of cardiovascular disease, and were not receiving medication for hypertension. A 1-day activity record during an ordinary weekday was used to estimate daily energy expenditure. Fasting glucose levels were measured at annual health examinations performed in May from 1994 to 2001.Results Over a 7-year follow-up period the relative risk of IFG and Type 2 diabetes decreased with increasing daily energy expenditure after controlling for potential predictors of diabetes (p<0.001 and p=0.001 for trend respectively). The age-adjusted relative risk of IFG or Type 2 diabetes decreased with increasing energy expenditure on occupational physical activity, brisk walking, riding on vehicles (standing position) to and from work and other physical activities (all p<0.001 for trend). The association with riding on vehicles (standing position) and other physical activities remained after controlling for other potential confounders of diabetes (p=0.026 and p=0.003 for trend respectively). Results of stratified analyses by the presence or absence of different risk factors for diabetes revealed that the risk of IFG or Type 2 diabetes was inversely related to daily energy expenditure both in men at low risk of diabetes and those at high risk.Conclusions/interpretation Physical activity in daily life is inversely associated with the risk of developing IFG or Type 2 diabetes.