Glucose tolerance and physical activity level in people with spinal cord injury

Study design: Cross-sectional, observational study. Objectives: To evaluate the associations of physical activity and neurological lesion level with glucose tolerance in people with spinal cord injury (SCI). Setting: New South Wales, Australia. Methods: Twenty-five people (5 women, 20 men) with SCI (>6 months post-injury) aged between 18 and 65 years were recruited. Exclusion criteria included known coronary heart disease, stroke or diabetes. Participants underwent an oral glucose tolerance test. Fasting and 2-h plasma glucose concentrations were classified according to the World Health Organization categories of glycemia. Participants also completed the Physical Activity Scale for Individuals with Physical Disabilities and mean MET-hours day −1 was calculated. Associations with the 2-h plasma glucose concentration were calculated through multiple and stepwise regressions. Results: Participants presented with complete or incomplete tetraplegia ( n =11 TETRA) or complete or incomplete paraplegia ( n =14 PARA) with neurological lesion levels ranging from C3/4 to T12. Mean 2-h plasma glucose was 7.13±2.32 mmol l −1 . Nine participants had disordered glycemia ( n =6 TETRA; n =3 PARA) and the remaining participants had normal glucose tolerance. Those participants with normal glucose tolerance participated in more moderate-vigorous and strength exercise and undertook more non-exercise-related mobility than those with disordered glycemia. Physical activity and age, but not lesion level were independent determinants of 2-h plasma glucose concentration ( r =0.683, P =0.001), explaining 47% of the variance. Conclusion: Physical activity level is independently associated with glucose tolerance in people with SCI. Non-exercise activity may also be important for maintaining normal glycemia.