Association Between Sedentary Behavior and Glycemic Control Among Adults in Peshawar, Pakistan: A Gender Base Analysis of Type 2 Diabetic Mellitus

Abstract

The Global surge in Type 2 Diabetes Mellitus (T2DM) is strongly linked to modifiable risk factors, particularly sedentary behavior. While this association is well-established in Western contexts, there is a critical lack of data from specific socio-cultural environments like Pakistan, where unique lifestyle patterns, dietary habits, and gender roles may alter this relationship. Peshawar represents a high-risk population where understanding the intricate dynamics between sedentariness, gender, and glycemic control is essential for crafting effective local public health strategies. This study aimed to investigate this correlation and determine the gender-specific prevalence of T2DM in this understudied adult population. An analytical observational study was conducted with a sample of 250 adults from Peshawar, intentionally selected for high sedentary behavior. The study group was comprised of 160 females (64%) and 90 males (36%), with a mean age of 49.92 (±8.923) years. Data collection included measured biomarkers such as HbA1c, Random Blood Sugar (RBS), and Body Mass Index (BMI) alongside self-reported average daily sedentary time. Statistical analysis employed Pearson’s correlation to assess bivariate relationships and multiple linear regression to model the predictors of HbA1c, controlling for age and gender.  The study found an alarmingly high overall T2DM prevalence of 86%. Participants exhibited highly sedentary behavior (mean 7.29±0.71 hours/day) and poor glycemic control (mean HbA1c 9.54±2.49%; mean RBS 238.22±68.31 mg/dL). A strong, statistically significant positive correlation was found between sedentary time and HbA1c (r=0.823, p<0.01) and RBS (r=0.625, p<0.01). Regression analysis confirmed sedentary time as the strongest significant predictor of elevated HbA1c (β=0.820, p<0.001), while age and gender were non-significant predictors. A notable gender disparity was observed, with a higher T2DM prevalence among females (87.5%) compared to males (83.3%). This study provides compelling evidence of a powerful correlation between prolonged sedentary behavior and poor glycemic control in adults in Peshawar, with the burden of T2DM disproportionately affecting women. These findings underscore the critical need for public health interventions aimed at reducing sedentary time to mitigate the growing diabetes epidemic in this region.

Key words: Sedentary lifestyle, Type 2 diabetes, HbA1c, Random blood sugar, Body mass index, correlation.