Healthy Lifestyle Score and Glycemic Control in Type 2 Diabetes Mellitus Patients: A City-Wide Survey in China

Background: Few studies have investigated the combined impact of healthy lifestyle factors on glycemic control. Our study aimed to examine the associations of a healthy lifestyle score (HLS) with glycemic control and to explore the interactive effects of lifestyle factors among patients with type 2 diabetes mellitus (T2DM) in China. Methods: This cross-sectional study was conducted among T2DM patients based on the health management of residents from Guangzhou, China. Good glycemic control was defined as fasting plasma glucose < 7.0 mmol/L. HbA1c < 7.0% was also defined as good glycemic control in sensitivity analysis. The HLS was defined as including physical activity, waist circumference, body mass index, dietary habit, smoking, and alcohol consumption. Logistic regression models were used to examine the associations and interactions between the lifestyle factors and glycemic control. Results: Compared with participants with an HLS ≤ 2, the odds ratios (95% confidence intervals) for an HLS of 3, 4, 5, and 6 were 0.82 (0.77–0.87), 0.74 (0.70–0.79), 0.61 (0.57–0.65), and 0.56 (0.53–0.60), respectively. Significant interactions of healthy lifestyle factors in relation to glycemic control were shown (P(interaction) < 0.05). Conclusions: A healthier lifestyle was significantly associated with good glycemic control in patients with T2DM, and combined healthy lifestyle factors had a better effect than considering them individually.