Abstract:
ackground: Prediabetes is a reversible condition where
lifestyle changes can prevent type 2 diabetes. While physical
activity is crucial for management, traditional glycemic markers
like HbA1c may not adequately reflect short-term exercise
effects. Serum fructosamine, indicating average blood sugar
levels over 1-3 weeks, is a more responsive biomarker but is
under-researched in prediabetic populations, especially in the
Gulf region.
Aim: To evaluate the association between regular physical
activity and short-term glycemic control, indexed by serum
fructosamine, in adults with prediabetes, and to examine
whether exercise modality (aerobic, resistance, or combined)
differentially influences short-term and long-term glycemic
indices, body composition, and insulin sensitivity.
Methods: A cross-sectional analytical study at Thumbay
Hospital and Thumbay Laboratories in Ajman, UAE, was
conducted from November 2025 to April 2026, involving
78 adults aged 18–65 with prediabetes. Participants were
stratified by physical activity levels using the IPAQ-SF. Various
measurements, including anthropometric indices, fasting
plasma glucose, HbA1c, fasting insulin, HOMA-IR, and serum
fructosamine, were taken under standardized conditions. The
Hemoglobin Glycation Index (HGI) was calculated based on
the difference between observed and predicted HbA1c levels.
Statistical analyses included Mann–Whitney U and Kruskal
Wallis tests for between-group comparisons and Spearman's
coefficient for correlations, with a significance level set at p <
0.05.
Results: The study described a predominantly male (73.1%)
and middle-aged cohort, with 82.1% classified as overweight
or obese. Participants were 44.9% active and 55.1% sedentary,
with no significant differences in fasting glucose, insulin,
HOMA-IR, HbA1c, fructosamine, or BMI between the two
groups. Within the active subgroup, aerobic exercisers (n = 13)
had the lowest median BMI (25.7 kg/m²) and fasting insulin
but the highest fructosamine levels. However, these differences
diminished in multivariable regression models, indicating that
male sex and BMI were key determinants of fasting insulin and
HOMA-IR. Sedentary status was linked to higher HbA1c, while
age correlated with higher fructosamine.
Conclusions: Self-reported physical activity did not affect
glycemic outcomes in prediabetics, probably owing to
misclassification and limited exercise benefits. Despite the short
sample size, exploratory analysis suggested that aerobic exercise
may improve insulin sensitivity and body composition while
resistance training may improve glycemic exposure. Combining
exercise may be beneficial, requiring additional study. In
equivocal HbA1c findings, short-term glycemic indicators are
important, but the absence of serum albumin measurement
and albumin adjustment for fructosamine in exercise group
comparisons limits interpretations.
Keywords. Prediabetes, physical activity, exercise modality,
fructosamine, HbA1c, HOMA-IR, hemoglobin glycation index,
short-term glycemic control, United Arab Emirates.
