Abstract
Monitoring and modeling population health is essential for understanding the impact of lifestyle behaviors and pharmacologic therapies on chronic disease management. In this study, we used a nationwide Japanese health insurance claims and health checkup database to investigate the associations between physical activity and glycemic control among 24,830 treatment-naïve adults with type 2 diabetes receiving DPP-4 inhibitors, SGLT2 inhibitors, or metformin. The odds of achieving hemoglobin A1c (HbA1c) < 6.5% at follow-up were assessed according to physical activity status, determined using standardized questionnaires. In this real-world population, physically active individuals had higher odds of achieving glycemic control than sedentary individuals among those treated with DPP-4 inhibitors or SGLT2 inhibitors, whereas no statistically significant association was observed among those treated with metformin. These findings support the potential value of integrating physical activity with pharmacologic therapy in type 2 diabetes management in real-world clinical settings.
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Data availability
The data that support the findings of this study are available from JMDC Inc. (Tokyo, Japan). Restrictions apply to the availability of these data, which were used under license for the current study and are therefore not publicly available. Data are available from the corresponding author (kenta.yamamoto@thu.ac.jp) upon reasonable request and with permission from JMDC Inc.
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We would like to thank Editage (www.editage.com) for the English language editing.
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K.Y. and M.M. formulated the research questions and designed the study; K.Y., R.K., and A.I. analyzed the data; K.Y., R.K., A.I., and M.M. performed data interpretation; K.Y. and M.M. drafted the manuscript; K.Y. had the primary responsibility for the final contents; and all authors read and approved the final manuscript.
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This study was supported by the JSPS KAKENHI grant (grant numbers: JP20K11422, JP2011422S, and JP23K10722) to K. Yamamoto.
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Yamamoto, K., Kai, R., Inano, A. et al. Combined effects of physical activity and diabetes medications on glycemic control: a real-world data study. Sci Rep (2026). https://doi.org/10.1038/s41598-026-35396-7
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DOI: https://doi.org/10.1038/s41598-026-35396-7
