Healthy lifestyle index development and its association with type 2 diabetes mellitus status among teachers

Abstract

Background

Type 2 diabetes mellitus (T2DM) is a significant health concern and imposes a substantial burden on society. Although leading a healthy lifestyle is an effective means of reducing the risk of T2DM, the complex interplay of diverse lifestyle factors necessitates a comprehensive assessment.

Objective

This study aims to develop and investigate the association between a healthy lifestyle index (HLI) and T2DM among teachers.

Methods

A total of 11412 teachers from schools in Peninsular Malaysia were recruited. The HLI score was constructed using both unweighted and regression-weighted methods. A comparison was conducted and the index with the lowest AIC was considered the best. The final model with an index and other covariates was then optimised, followed by model validations.

Results

All teachers (n = 11412) who completed the baseline survey were included in the analysis. Majority were females, Malays, married, and had at least a bachelor’s degree. Among the developed indexes comprised of waist circumference, physical activity, sleep duration, and mental health status (e.g. stress, anxiety, and depression). The B HLI index is the best proxy for teachers’ lifestyles associated with T2DM. The optimised regression showed that an increase of an HLI score reduced the odds of T2DM by 59%. The model had an adjusted R² of 26.8% and an area under the curve of 0.837. The model was externally validated with the validation dataset by achieving an adequate C-statistic value of 0.798.

Conclusion

A higher HLI score was associated with a reduced odd of T2DM. This finding highlights the importance of integrating multidimensional lifestyle modification rather than singular ones when developing health promotion strategies.