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Physical Activity and Mortality in Individuals With Diabetes Mellitus A Prospective Study and Meta-analysis

Sluik, Diewertje; Buijsse, Brian; Muckelbauer, Rebecca; Kaaks, Rudolf; Teucher, Birgit; Johnsen, Nina Fons; Tjonneland, Anne; Overvad, Kim; Ostergaard, Jane Nautrup and Amiano, Pilar, et al. (2012) In Archives of Internal Medicine 172(17). p.1285-1295
Abstract
Background: Physical activity (PA) is considered a cornerstone of diabetes mellitus management to prevent complications, but conclusive evidence is lacking. Methods: This prospective cohort study and meta-analysis of existing studies investigated the association between PA and mortality in individuals with diabetes. In the EPIC study (European Prospective Investigation Into Cancer and Nutrition), a cohort was defined of 5859 individuals with diabetes at baseline. Associations of leisure-time and total PA and walking with cardiovascular disease (CVD) and total mortality were studied using multivariable Cox proportional hazards regression models. Fixed-and random-effects meta-analyses of prospective studies published up to December 2010 were... (More)
Background: Physical activity (PA) is considered a cornerstone of diabetes mellitus management to prevent complications, but conclusive evidence is lacking. Methods: This prospective cohort study and meta-analysis of existing studies investigated the association between PA and mortality in individuals with diabetes. In the EPIC study (European Prospective Investigation Into Cancer and Nutrition), a cohort was defined of 5859 individuals with diabetes at baseline. Associations of leisure-time and total PA and walking with cardiovascular disease (CVD) and total mortality were studied using multivariable Cox proportional hazards regression models. Fixed-and random-effects meta-analyses of prospective studies published up to December 2010 were pooled with inverse variance weighting. Results: In the prospective analysis, total PA was associated with lower risk of CVD and total mortality. Compared with physically inactive persons, the lowest mortality risk was observed in moderately active persons: hazard ratios were 0.62 (95% CI, 0.49-0.78) for total mortality and 0.51 (95% CI, 0.32-0.81) for CVD mortality. Leisure-time PA was associated with lower total mortality risk, and walking was associated with lower CVD mortality risk. In the meta-analysis, the pooled random-effects hazard ratio from 5 studies for high vs low total PA and all-cause mortality was 0.60 (95% CI, 0.49-0.73). Conclusions: Higher levels of PA were associated with lower mortality risk in individuals with diabetes. Even those undertaking moderate amounts of activity were at appreciably lower risk for early death compared with inactive persons. These findings provide empirical evidence supporting the widely shared view that persons with diabetes should engage in regular PA. (Less)
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published
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Archives of Internal Medicine
volume
172
issue
17
pages
1285 - 1295
publisher
American Medical Association
external identifiers
  • wos:000309079300002
  • scopus:84867168142
ISSN
0003-9926
DOI
10.1001/archinternmed.2012.3130
language
English
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yes
id
ea7ea2c7-c29b-45e1-b8e0-d82dcaef234c (old id 3190122)
date added to LUP
2012-12-03 07:10:37
date last changed
2017-10-01 03:11:22
@article{ea7ea2c7-c29b-45e1-b8e0-d82dcaef234c,
  abstract     = {Background: Physical activity (PA) is considered a cornerstone of diabetes mellitus management to prevent complications, but conclusive evidence is lacking. Methods: This prospective cohort study and meta-analysis of existing studies investigated the association between PA and mortality in individuals with diabetes. In the EPIC study (European Prospective Investigation Into Cancer and Nutrition), a cohort was defined of 5859 individuals with diabetes at baseline. Associations of leisure-time and total PA and walking with cardiovascular disease (CVD) and total mortality were studied using multivariable Cox proportional hazards regression models. Fixed-and random-effects meta-analyses of prospective studies published up to December 2010 were pooled with inverse variance weighting. Results: In the prospective analysis, total PA was associated with lower risk of CVD and total mortality. Compared with physically inactive persons, the lowest mortality risk was observed in moderately active persons: hazard ratios were 0.62 (95% CI, 0.49-0.78) for total mortality and 0.51 (95% CI, 0.32-0.81) for CVD mortality. Leisure-time PA was associated with lower total mortality risk, and walking was associated with lower CVD mortality risk. In the meta-analysis, the pooled random-effects hazard ratio from 5 studies for high vs low total PA and all-cause mortality was 0.60 (95% CI, 0.49-0.73). Conclusions: Higher levels of PA were associated with lower mortality risk in individuals with diabetes. Even those undertaking moderate amounts of activity were at appreciably lower risk for early death compared with inactive persons. These findings provide empirical evidence supporting the widely shared view that persons with diabetes should engage in regular PA.},
  author       = {Sluik, Diewertje and Buijsse, Brian and Muckelbauer, Rebecca and Kaaks, Rudolf and Teucher, Birgit and Johnsen, Nina Fons and Tjonneland, Anne and Overvad, Kim and Ostergaard, Jane Nautrup and Amiano, Pilar and Ardanaz, Eva and Bendinelli, Benedetta and Pala, Valeria and Tumino, Rosario and Ricceri, Fulvio and Mattiello, Amalia and Spijkerman, Annemieke M. W. and Monninkhof, Evelyn M. and May, Anne M. and Franks, Paul and Nilsson, Peter M. and Wennberg, Patrik and Rolandsson, Olov and Fagherazzi, Guy and Boutron-Ruault, Marie-Christine and Clavel-Chapelon, Francoise and Huerta Castano, Jose Maria and Gallo, Valentina and Boeing, Heiner and Nothlings, Ute},
  issn         = {0003-9926},
  language     = {eng},
  number       = {17},
  pages        = {1285--1295},
  publisher    = {American Medical Association},
  series       = {Archives of Internal Medicine},
  title        = {Physical Activity and Mortality in Individuals With Diabetes Mellitus A Prospective Study and Meta-analysis},
  url          = {http://dx.doi.org/10.1001/archinternmed.2012.3130},
  volume       = {172},
  year         = {2012},
}