The influence of physical activity on vascular complications and mortality in patients with type 2 diabetes mellitus
Article first published online: 11 JUN 2013
© 2013 John Wiley & Sons Ltd
Diabetes, Obesity and Metabolism
Volume 15, Issue 11, pages 1008–1012, November 2013
How to Cite
Blomster, J. I., Chow, C. K., Zoungas, S., Woodward, M., Patel, A., Poulter, N. R., Marre, M., Harrap, S., Chalmers, J. and Hillis, G. S. (2013), The influence of physical activity on vascular complications and mortality in patients with type 2 diabetes mellitus. Diabetes, Obesity and Metabolism, 15: 1008–1012. doi: 10.1111/dom.12122
- Issue published online: 7 OCT 2013
- Article first published online: 11 JUN 2013
- Accepted manuscript online: 15 MAY 2013 08:57AM EST
- Manuscript Accepted: 23 APR 2013
- Manuscript Revised: 24 MAR 2013
- Manuscript Received: 4 FEB 2013
- cardiovascular disease;
- diabetes complications;
There is limited evidence regarding the association between physical activity and vascular complications, particularly microvascular disease, in patients with type 2 diabetes.
From the 11 140 patients in the ADVANCE (Action in Diabetes and Vascular Disease: Preterax and Diamicron modified release Controlled Evaluation) trial, the effect of physical activity, categorized as none, mild, moderate or vigorous, and the number of sessions within a week, was examined in multivariable regression models adjusted for potential confounders. The study end-points were major cardiovascular events, microvascular complications and all-cause mortality.
Forty-six percent of participants reported undertaking moderate to vigorous physical activity for >15 min at least once in the previous week. During a median of 5 years of follow-up, 1031 patients died, 1147 experienced a major cardiovascular event and 1136 a microvascular event. Compared to patients who undertook no or mild physical activity, those reporting moderate to vigorous activity had a decreased risk of cardiovascular events (HR: 0.78, 95% CI: 0.69–0.88, p < 0.0001), microvascular events (HR: 0.85, 95% CI: 0.76–0.96, p = 0.010) and all-cause mortality (HR: 0.83, 95% CI: 0.73–0.94, p = 0.0044).
Moderate to vigorous, but not mild, physical activity is associated with a reduced incidence of cardiovascular events, microvascular complications and all-cause mortality in patients with type 2 diabetes.