Sex Differences in Diabetes Risk and the Effect of Intensive Lifestyle Modification in the Diabetes Prevention Program

Publication Description
Sex Differences in Diabetes Risk and the Effect of Intensive Lifestyle Modification in the Diabetes Prevention Program Leigh Perreault , MD 1 , Yong Ma , MS 2 , Sam Dagogo-Jack , MD 3 , Edward Horton , MD 4 , David Marrero , MD 5 , Jill Crandall , MD 6 , Elizabeth Barrett-Connor , MD 7 and for the Diabetes Prevention Program 1 University of Colorado Health Sciences Center, Aurora, Colorado 2 Coordinating Center, George Washington University, Rockville, Maryland 3 University of Tennessee, Memphis, Tennessee 4 Joslin Diabetes Center, Boston, Massachusetts 5 Indiana University, Indianapolis, Indiana 6 Albert Einstein College of Medicine, Bronx, New York 7 University of California, San Diego, La Jolla, California Corresponding author: The Diabetes Prevention Program Coordinating Center, dppmail{at}biostat.bsc.gwu.edu Abstract OBJECTIVE —In participants of the Diabetes Prevention Program (DPP) randomized to intensive lifestyle modification (ILS), meeting ILS goals strongly correlated with prevention of diabetes in the group as a whole. Men met significantly more ILS goals than women but had a similar incidence of diabetes. Therefore, we explored sex differences in risk factors for diabetes and the effect of ILS on risk factors. RESEARCH DESIGN AND METHODS —Baseline risk factors for diabetes and percent change in risk factors over the first year in men versus women were compared using Wilcoxon's rank-sum tests. RESULTS —At baseline, men were older and had a larger waist circumference; higher fasting plasma glucose concentration, caloric intake, and blood pressure; and lower HDL cholesterol and corrected insulin response than women, who were less physically active and had a higher BMI ( P < 0.01 for all comparisons). Over the first year of the DPP, no sex difference in risk factors for diabetes was observed for those who lost <3% body weight. Weight loss of 3–7% body weight yielded greater decreases in 2-h glucose ( P < 0.01), insulin concentration ( P < 0.04), and insulin resistance ( P < 0.03) in men than in women. Weight loss of >7% body weight resulted in greater decreases in 2-h glucose ( P < 0.01), triglyceride level ( P < 0.01), and A1C ( P < 0.03) in men than in women. CONCLUSIONS —Weight loss >3% body weight yielded greater reduction in risk factors for diabetes in men than in women. Despite the more favorable effects of ILS in men, baseline risk factors were more numerous in men and likely obscured any sex difference in incident diabetes. Footnotes Published ahead of print at http://care.diabetesjournals.org on 20 March 2008. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details. The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact. Accepted March 18, 2008. Received January 4, 2007. DIABETES CARE

Primary Author
Leigh Perreault
Yong Ma
Sam Dagogo-Jack
Edward Horton
David Marrero
Jill Crandall
Elizabeth Barrett-Connor

Volume
31

Issue
7

Start Page
1416

Other Pages
1421

Publisher
American Diabetes Association

URL
http://care.diabetesjournals.org/content/31/7/1416.abstract

PMID
18356403

PMCID
PMC2453677



Reference Type
Journal Article

Periodical Full
Diabetes Care

Publication Year
2008

Publication Date
Jul 1,

Place of Publication
United States

ISSN/ISBN
0149-5992

Document Object Index
10.2337/dc07-2390