PROSPECTIVE-STUDY OF RISK-FACTORS FOR DEVELOPMENT OF NON-INSULIN-DEPENDENT DIABETES IN MIDDLE-AGED BRITISH MEN

Objective-To determine the risk factors for noninsulin dependent diabe tes in a cohort representative of middle aged British men. Design-Pros pective study. Subjects and setting-7735 men aged 40-59, drawn from on e group practice in each of 24 towns in Britain. Known and probable ca ses of diabetes at screening (n=158) were excluded. Main outcome measu res-Non-insulin dependent diabetes (doctor diagnosed) over a mean foll ow up period of 12 . 8 years. Results-There were 194 new cases of non- insulin dependent diabetes. Body mass index was the dominant risk fact or for diabetes, with an age adjusted relative risk (upper fifth to lo wer fifth) of 11 . 6; 95% confidence interval 5 . 4 to 16 . 8. Men eng aged in moderate levels of physical activity had a substantially reduc ed risk of diabetes, relative to the physically inactive men, after ad justment for age and body mass index (0 . 4; 0 . 2 to 0 . 7), an assoc iation which persisted in full multivariate analysis. A nonlinear rela tion between alcohol intake and diabetes was observed, with the lowest risk among moderate drinkers (16-42 units/week) relative to the basel ine group of occasional drinkers (0 . 6; 0 . 4 to 1 . 0). Additional s ignificant predictors of diabetes in multivariate analysis included se rum triglyceride concentration, high density lipoprotein cholesterol c oncentration (inverse association), heart rate, uric acid concentratio n, and prevalent coronary heart disease. Conclusion-These finding emph asise the interrelations between risk factors for non-insulin dependen t diabetes and coronary heart disease and the potential value of an in tegrated approach to the prevention of these conditions based on the p revention of obesity and the promotion of physical activity.