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The influence of physical activity on vascular complications and mortality in patients with type 2 diabetes mellitus
Author(s) -
Blomster J. I.,
Chow C. K.,
Zoungas S.,
Woodward M.,
Patel A.,
Poulter N. R.,
Marre M.,
Harrap S.,
Chalmers J.,
Hillis G. S.
Publication year - 2013
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/dom.12122
Subject(s) - medicine , diabetes mellitus , incidence (geometry) , vascular disease , confounding , type 2 diabetes , proportional hazards model , disease , type 2 diabetes mellitus , cardiology , endocrinology , physics , optics
Aims There is limited evidence regarding the association between physical activity and vascular complications, particularly microvascular disease, in patients with type 2 diabetes. Methods 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. Results 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). Conclusions 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.