Association Between Physical Activity and Type 2 Diabetes Using the International Physical Activity Questionnaires: A Case-Control Study at a Health Promoting Hospital in Chiang Mai, Northern Thailand

Figures & data

Table 1 Inclusion and Exclusion Criteria

	Case	Control
Inclusion	•Age: 25–74 years. •Either sex. •All races and religions. •Being able to undertake a face-to-face interview including measurements. • Newly diagnosed T2DM Patients attending Sanpatong district community hospital who were diagnosed within six months before data collection. • Diagnosed as T2DM according to Thailand national guideline for diabetes such as fasting plasma glucose level more than 126 mg/dL (7.0 mmol/L) or two hours OGTT level more than 200mg/dL (11.1 mmol/L).	•Age: 25–74 years. •Either sex. •All races and religions. •Being able to undertake a face-to-face interview including measurements. •Community residents who are not diabetes. • The diagnosis of diabetes was excluded by blood glucose screening test that is routinely used for health checkup.
Exclusion	•Non-residents, tourists, or foreigners •Those not willing to participate •Those diagnosed with chronic diseases like kidney failure

Figure 1 Data collection procedure for samples (cases and controls).

Table 2 Characteristics of Study Participants (n = 300)

Variables	Control (n = 150) (%)	Case (n = 150) (%)	Value χ2	P-value
Age
Under 60 years	85 (56.7)	73 (48.7)	1.93	0.165
60 years and older	65 (43.3)	77 (53.3)
Sex
Male	41 (27.3)	63 (42.0)	7.12	0.008^(a)
Female	109 (72.7)	87 (58.0)
Marriage status
Currently not married	43 (28.7)	41 (27.3)	0.07	0.797
Currently married	107 (71.3)	109 (72.7)
Level of education
No formal schooling	19 (12.7)	13 (8.7)
Primary, secondary, or high school completed	131 (87.3)	137 (91.3)	1.26	0.262
Income sufficiency for living expenses
Insufficient	72 (48.0)	83 (55.3)	1.62	0.204
Sufficient	78 (52.0)	67 (44.7)
Average household monthly income (Baht/month)^(b)
< 20,433	148 (98.7)	140 (94.0)	4.67	0.035^(a)
≥ 20,433	2 (1.3)	9 (6.0)
Family diabetes history
No	128 (85.3)	95 (63.3)	19.03	<0.001^(a)
Yes	22 (14.7)	55 (36.7)
Hypertension^(c)
No	95 (65.5)	29 (19.3)	64.5	<0.001^(a)
Yes	50 (34.5)	121 (80.7)
Alcohol intake
Currently not drinking	92 (61.3)	115 (76.7)	8.24	0.004^(a)
Regularly drinking	58 (38.7)	35 (23.3)
Smoking
Currently not smoking	133 (88.7)	131 (87.3)	0.13	0.722
Regularly smoking	17 (11.3)	19 (12.7)
BMI
<25	92 (61.3)	85 (56.7)	0.68	0.411
≥25	58 (38.7)	65 (43.3)
High Waist Circumference ^(d)
No	60 (40.3)	51 (34.0)
Yes	89 (59.7)	99 (66.0)	1.26	0.262

Notes: ^(a)P-value is less than 0.05. ^(b)For average household monthly income, one case data is missing. ^(c)Those who had high blood pressure at the time of visiting the hospital and those who had taken medicine to treat raised blood pressure during the past two weeks were categorized as hypertension. ^(d)High Waist Circumference defined as waist ≥90 cm for male and waist ≥80 cm for female. One case data is missing for waist circumference.

Table 3 The Proportion of Receiving Education Related Physical Activity (PA) (n = 300)

Variables	Control (n = 150) n (%)	Case (n = 150) n (%)	P-value
Have you ever received education related to PA?
No	31 (20.7)	3 (2.0)	<0.001^(a)
Yes	119 (79.3)	147 (98.0)

Note: ^(a)P-value is less than 0.05.

Figure 2 The sources from which participants received education related to physical activity (n = 300, multiple answers).

Note: Sources are not mutually exclusive.

Table 4 The Amount and Level of Physical Activity of the Participants (n = 300)

Physical Activity	Total (N = 300)	Control (n = 150)	Case (n = 150)	P-value
Total METs min/week				<0.001^(a)
Mean ± SD	3563.3 ± 5051.4	2826.9 ± 4414.2	4299.8 ± 5534.2
Median (IQR)	1795.0 (592.5–4075.5)	1140.0 (198–3000)	2726.3 (1314–4746)
Vigorous METs min/week (8.0 METs)				<0.001^(a)
Mean ± SD	1699.2 ± 4148.5	1057.6 ± 3138.3	2340.8 ± 4884.4
Median (IQR)	480.0 (0.0–1320.0)	0.0 (0.0–720.0)	720.0 (0.0–1800.0)
Moderate METs min/week (4.0 METs)				0.236
Mean ± SD	608.3 ± 1145.6	753.6 ± 1455.3	463.1 ± 687.9
Median (IQR)	240.0 (0.0–840.0)	240.0 (0.0–840.0)	240.0 (0.0–720.0)
Walking METs min/week (3.3 METs)				<0.001^(a)
Mean ± SD	1255.8 ± 1994.3	1015.7 ± 2368.7	1495.9 ±1501.4
Median (IQR)	495.0 (66.0–1386.0)	140.3 (0.0–693.0)	1386.0 (396.0–2079.0)
PA level group (N (%))				<0.001^(b)
Low	74 (24.7)	51 (34.0)	23 (15.3)
Moderate	93 (31.0)	49 (32.7)	44 (29.3)
High	133 (44.3)	50 (33.3)	83 (55.3)

Notes: ^(a)P-value is less than 0.05 by Mann–Whitney test. ^(b)P-value is less than 0.05 by chi-square test.

Figure 3 Total METs min/week among those with and without diabetes (n = 300).

Note: Excludes outside values.

Abbreviation: METs: the metabolic equivalents.

Figure 4 METs min/week from walking, moderate exercise, and vigorous exercise among patients with diabetes and the non-diabetes control group (n = 300).

Note: Excludes outside values.

Abbreviation: METs: the metabolic equivalents.

Table 5 Factors Associated with Diabetes Between Cases and Controls Through Multiple Logistic Regression Analysis (n = 300)

Variable	Total = 300	Control = 150	Case = 150	Univariate Analysis		Multivariable Analysis^(b)
		N (%)	N (%)	OR (95% CI)	P-value	Adjusted OR (95% CI)	P-value
Low PA	89	56 (62.9)	33 (37.1)	Ref		Ref
Moderate PA	78	44 (56.4)	34 (43.6)	1.99 (1.05–3.77)	0.035^(a)	2.04 (1.06–3.94)	0.034^(a)
High PA	133	50 (37.6)	83 (62.4)	3.68 (2.01–6.74)	<0.001^(a)	3.67 (1.96–6.87)	<0.001^(a)
Female	196	109 (55.6)	87 (44.4)	Ref		Ref
Male	104	41 (39.4)	63 (60.6)	1.93 (1.19–3.21)	0.008^(a)	1.52 (0.91–2.55)	0.110
BMI < 25	177	92 (52.0)	85 (48.0)	Ref		Ref
BMI ≥ 25	123	58 (47.2)	65 (52.8)	1.21 (0.77–1.92)	0.411	1.23 (0.75–2.01)	0.406
Age < 60	158	85 (53.8)	73 (46.2)	Ref		Ref
Age ≥ 60	142	65 (45.8)	77 (54.2)	1.38 (0.88–2.17)	0.166	1.61 (0.99–2.62)	0.056
Average household monthly income (Baht/month)
<20,433	288	148 (51.4)	140 (48.6)	Ref		Ref
≥20,433	11	2 (18.2)	9 (81.8)	4.76 (1.01–22.4)	0.049^(a)	4.34 (0.88–21.39)	0.071

Notes: ^(a)P-value is less than 0.05. ^(b)Adjusted for sex, BMI, age, and average household monthly income.