{"doi":"10.2337/figshare.13103333","title":"The Impact of Physical Activity (PA) on the Prevention of Type 2 Diabetes; Evidence and Lessons Learned from the Diabetes Prevention Program (DPP), a Long-Standing Clinical Trial Incorporating Subjective and Objective Activity Measures","abstract":"<b>Objective:</b> Across the DPP follow-up, cumulative diabetes incidence remained lower in the lifestyle compared to placebo and metformin randomized groups and could not be explained by weight. Collection of self-reported PA (yearly) with cross-sectional objective PA (in follow-up) allowed for examination of PA and its long-term impact on diabetes prevention. <p><b>Research Design and Methods:</b> Yearly self-reported PA and diabetes assessment, OGTT, (fasting glucose semi-annually) was collected for 3232 participants with one accelerometry assessment 11-13 years after randomization (n=1,793). Mixed models determined PA differences across treatment groups. The association between PA and diabetes incidence was examined using Cox proportional hazards models. </p> <p><b>Results:</b> There was a 6% decrease (Cox proportional HR 0.94 [0.92, 0.96]; P< 0.001) in diabetes incidence per 6 MET-hrs/week increase in time-dependent PA for the entire cohort over an average 12 years (controlled for age, sex, baseline PA and weight). The effect of PA was greater (12% decrease) among participants less active at baseline (<7.5 MET-hrs/week) (n=1338; HR 0.88 [0.83, 0.93] P<0.0001) with stronger findings for lifestyle participants. Lifestyle had higher cumulative PA compared with metformin or placebo (p<0.0001) and higher accelerometry total minutes/day measured in follow-up (P=0.001 and 0.047). All associations remained significant with weight in the models.</p> <p><b>Conclusions:</b> PA was inversely related to incident diabetes in the entire cohort across the study with cross-sectional accelerometry results supporting these findings. This highlights the importance of PA within lifestyle intervention efforts designed to prevent diabetes and urge health-care providers to consider both PA and weight when counseling high-risk patients.</p>","journal":null,"year":2020,"id":125969,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9348,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":307252,"name":"Bonny Rockette‐Wagner","orcid":"0000-0002-4096-917X","position":1,"is_corresponding":false},{"id":307253,"name":"Sharon L. Edelstein","orcid":"0000-0001-8457-4404","position":2,"is_corresponding":false},{"id":74149,"name":"George A. Bray","orcid":"0000-0001-9945-8772","position":3,"is_corresponding":false},{"id":307254,"name":"Linda M. Delahanty","orcid":"0000-0002-1525-3559","position":4,"is_corresponding":false},{"id":307255,"name":"Mary A. Hoskin","orcid":"0000-0002-4964-2763","position":5,"is_corresponding":false},{"id":307256,"name":"Edward S. Horton","orcid":"0000-0002-5670-3157","position":6,"is_corresponding":false},{"id":307257,"name":"Elizabeth M. Venditti","orcid":"0000-0002-4124-6555","position":7,"is_corresponding":false},{"id":2870,"name":"William C. Knowler","orcid":"0000-0002-7004-5197","position":8,"is_corresponding":false},{"id":307251,"name":"Andrea M. Kriska","orcid":"0000-0002-3522-0869","position":0,"is_corresponding":true}],"reference_count":0,"raw_metadata":null,"created_at":"2026-07-18T23:15:19.482428Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}