PMCCPMCCPMCC

Search tips
Search criteria 

Advanced

 
Logo of bmjThe BMJ
 
BMJ. 1995 March 4; 310(6979): 560–564.
PMCID: PMC2548938

Prospective study of risk factors for development of non-insulin dependent diabetes in middle aged British men.

Abstract

OBJECTIVE--To determine the risk factors for noninsulin dependent diabetes in a cohort representative of middle aged British men. DESIGN--Prospective study. SUBJECTS AND SETTINGS--7735 men aged 40-59, drawn from one group practice in each of 24 towns in Britain. Known and probable cases of diabetes at screening (n = 158) were excluded. MAIN OUTCOME MEASURES--Non-insulin dependent diabetes (doctor diagnosed) over a mean follow up period of 12.8 years. RESULTS--There were 194 new cases of non-insulin dependent diabetes. Body mass index was the dominant risk factor for diabetes, with an age adjusted relative risk (upper fifth to lower fifth) of 11.6; 95% confidence interval 5.4 to 16.8. Men engaged in moderate levels of physical activity had a substantially reduced risk of diabetes, relative to the physically inactive men, after adjustment for age and body mass index (0.4; 0.2 to 0.7), an association which persisted in full multivariate analysis. A nonlinear relation between alcohol intake and diabetes was observed, with the lowest risk among moderate drinkers (16-42 units/week) relative to the baseline group of occasional drinkers (0.6; 0.4 to 1.0). Additional significant predictors of diabetes in multivariate analysis included serum triglyceride concentration, high density lipoprotein cholesterol concentration (inverse association), heart rate, uric acid concentration, and prevalent coronary heart disease. CONCLUSION--These findings emphasise the interrelations between risk factors for non-insulin dependent diabetes and coronary heart disease and the potential value of an integrated approach to the prevention of these conditions based on the prevention of obesity and the promotion of physical activity.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.1M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Jarrett RJ, Shipley MJ. Type 2 (non-insulin-dependent) diabetes mellitus and cardiovascular disease--putative association via common antecedents; further evidence from the Whitehall Study. Diabetologia. 1988 Oct;31(10):737–740. [PubMed]
  • Helmrich SP, Ragland DR, Leung RW, Paffenbarger RS., Jr Physical activity and reduced occurrence of non-insulin-dependent diabetes mellitus. N Engl J Med. 1991 Jul 18;325(3):147–152. [PubMed]
  • Manson JE, Rimm EB, Stampfer MJ, Colditz GA, Willett WC, Krolewski AS, Rosner B, Hennekens CH, Speizer FE. Physical activity and incidence of non-insulin-dependent diabetes mellitus in women. Lancet. 1991 Sep 28;338(8770):774–778. [PubMed]
  • Manson JE, Nathan DM, Krolewski AS, Stampfer MJ, Willett WC, Hennekens CH. A prospective study of exercise and incidence of diabetes among US male physicians. JAMA. 1992 Jul 1;268(1):63–67. [PubMed]
  • Ohlson LO, Larsson B, Björntorp P, Eriksson H, Svärdsudd K, Welin L, Tibblin G, Wilhelmsen L. Risk factors for type 2 (non-insulin-dependent) diabetes mellitus. Thirteen and one-half years of follow-up of the participants in a study of Swedish men born in 1913. Diabetologia. 1988 Nov;31(11):798–805. [PubMed]
  • Holbrook TL, Barrett-Connor E, Wingard DL. A prospective population-based study of alcohol use and non-insulin-dependent diabetes mellitus. Am J Epidemiol. 1990 Nov;132(5):902–909. [PubMed]
  • Stampfer MJ, Colditz GA, Willett WC, Manson JE, Arky RA, Hennekens CH, Speizer FE. A prospective study of moderate alcohol drinking and risk of diabetes in women. Am J Epidemiol. 1988 Sep;128(3):549–558. [PubMed]
  • Feskens EJ, Kromhout D. Cardiovascular risk factors and the 25-year incidence of diabetes mellitus in middle-aged men. The Zutphen Study. Am J Epidemiol. 1989 Dec;130(6):1101–1108. [PubMed]
  • Systemic treatment of early breast cancer by hormonal, cytotoxic, or immune therapy. 133 randomised trials involving 31,000 recurrences and 24,000 deaths among 75,000 women. Early Breast Cancer Trialists' Collaborative Group. Lancet. 1992 Jan 4;339(8784):1–15. [PubMed]
  • Lillioja S, Mott DM, Spraul M, Ferraro R, Foley JE, Ravussin E, Knowler WC, Bennett PH, Bogardus C. Insulin resistance and insulin secretory dysfunction as precursors of non-insulin-dependent diabetes mellitus. Prospective studies of Pima Indians. N Engl J Med. 1993 Dec 30;329(27):1988–1992. [PubMed]
  • Laws A, Reaven GM. Insulin resistance and risk factors for coronary heart disease. Baillieres Clin Endocrinol Metab. 1993 Oct;7(4):1063–1078. [PubMed]
  • Savage PJ, Saad MF. Insulin and atherosclerosis: villain, accomplice, or innocent bystander? Br Heart J. 1993 Jun;69(6):473–475. [PMC free article] [PubMed]
  • Shaper AG, Pocock SJ, Walker M, Cohen NM, Wale CJ, Thomson AG. British Regional Heart Study: cardiovascular risk factors in middle-aged men in 24 towns. Br Med J (Clin Res Ed) 1981 Jul 18;283(6285):179–186. [PMC free article] [PubMed]
  • Shaper AG, Pocock SJ, Walker M, Phillips AN, Whitehead TP, Macfarlane PW. Risk factors for ischaemic heart disease: the prospective phase of the British Regional Heart Study. J Epidemiol Community Health. 1985 Sep;39(3):197–209. [PMC free article] [PubMed]
  • Shaper AG, Cook DG, Walker M, Macfarlane PW. Prevalence of ischaemic heart disease in middle aged British men. Br Heart J. 1984 Jun;51(6):595–605. [PMC free article] [PubMed]
  • Shaper AG, Wannamethee G, Weatherall R. Physical activity and ischaemic heart disease in middle-aged British men. Br Heart J. 1991 Nov;66(5):384–394. [PMC free article] [PubMed]
  • Pocock SJ, Ashby D, Shaper AG, Walker M, Broughton PM. Diurnal variations in serum biochemical and haematological measurements. J Clin Pathol. 1989 Feb;42(2):172–179. [PMC free article] [PubMed]
  • Cook DG, Shaper AG, Thelle DS, Whitehead TP. Serum uric acid, serum glucose and diabetes: relationships in a population study. Postgrad Med J. 1986 Nov;62(733):1001–1006. [PMC free article] [PubMed]
  • Saad MF, Lillioja S, Nyomba BL, Castillo C, Ferraro R, De Gregorio M, Ravussin E, Knowler WC, Bennett PH, Howard BV, et al. Racial differences in the relation between blood pressure and insulin resistance. N Engl J Med. 1991 Mar 14;324(11):733–739. [PubMed]
  • Haffner SM, Stern MP, Hazuda HP, Mitchell BD, Patterson JK. Cardiovascular risk factors in confirmed prediabetic individuals. Does the clock for coronary heart disease start ticking before the onset of clinical diabetes? JAMA. 1990 Jun 6;263(21):2893–2898. [PubMed]
  • Chaturvedi N, McKeigue PM, Marmot MG. Relationship of glucose intolerance to coronary risk in Afro-Caribbeans compared with Europeans. Diabetologia. 1994 Aug;37(8):765–772. [PubMed]

Articles from The BMJ are provided here courtesy of BMJ Group