The association between cardiorespiratory fitness and impaired fasting glucose and type 2 diabetes mellitus in men

Ann Intern Med. 1999 Jan 19;130(2):89-96. doi: 10.7326/0003-4819-130-2-199901190-00002.


Background: Several studies show an inverse association between self-reported physical activity and type 2 diabetes. It is not known whether physical activity or cardiorespiratory fitness is associated with the onset of objectively determined impaired fasting glucose and type 2 diabetes.

Objective: To determine whether cardiorespiratory fitness, an objective marker of physical activity, is associated with risk for impaired fasting glucose and type 2 diabetes.

Design: Population-based prospective study.

Setting: Preventive medicine clinic.

Patients: 8633 nondiabetic men (of whom 7511 did not have impaired fasting glucose) who were examined at least twice.

Measurements: Cardiorespiratory fitness (determined by a maximal exercise test on a treadmill), fasting plasma glucose level, and other clinical and personal characteristics and incidence of impaired fasting glucose and type 2 diabetes.

Results: During an average follow-up of 6 years, 149 patients developed type 2 diabetes and 593 patients developed impaired fasting glucose. After age, cigarette smoking, alcohol consumption, and parental diabetes were considered, men in the low-fitness group (the least fit 20% of the cohort) at baseline had a 1.9-fold risk (95% CI, 1.5- to 2.4-fold) for impaired fasting glucose and a 3.7-fold risk (CI, 2.4- to 5.8-fold) for diabetes compared with those in the high-fitness group (the most fit 40% of the cohort). The risk for impaired fasting glucose was elevated in older men and those with a higher body mass index. Age, body mass index, blood pressure, triglyceride level, and a history of parental diabetes were also directly related to risk for type 2 diabetes.

Conclusions: Low cardiorespiratory fitness was associated with increased risk for impaired fasting glucose and type 2 diabetes. A sedentary lifestyle may contribute to the progression from normal fasting glucose to impaired fasting glucose and diabetes. Risk for type 2 diabetes was elevated in older persons and those with higher body mass index, blood pressure, and triglyceride levels and a parental history of diabetes.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Blood Glucose / metabolism*
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / physiopathology*
  • Exercise Test
  • Fasting
  • Glucose Intolerance / blood
  • Glucose Intolerance / epidemiology
  • Glucose Intolerance / physiopathology*
  • Glucose Tolerance Test
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Odds Ratio
  • Physical Fitness / physiology*
  • Prospective Studies
  • Regression Analysis
  • Risk Factors


  • Blood Glucose