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

  • Diewertje Sluik
  • Brian Buijsse
  • Rebecca Muckelbauer
  • Rudolf Kaaks
  • Birgit Teucher
  • Nina Fons Johnsen
  • Anne Tjonneland
  • Kim Overvad
  • Jane Nautrup Ostergaard
  • Pilar Amiano
  • Eva Ardanaz
  • Benedetta Bendinelli
  • Valeria Pala
  • Rosario Tumino
  • Fulvio Ricceri
  • Amalia Mattiello
  • Annemieke M. W. Spijkerman
  • Evelyn M. Monninkhof
  • Anne M. May
  • Paul Franks
  • Peter M. Nilsson
  • Patrik Wennberg
  • Olov Rolandsson
  • Guy Fagherazzi
  • Marie-Christine Boutron-Ruault
  • Francoise Clavel-Chapelon
  • Jose Maria Huerta Castano
  • Valentina Gallo
  • Heiner Boeing
  • Ute Nothlings
Publishing year: 2012
Language: English
Pages: 1285-1295
Publication/Series: Archives of Internal Medicine
Volume: 172
Issue: 17
Document type: Journal article review
Publisher: American Medical Association

Abstract english

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.


  • Endocrinology and Diabetes


  • Genetic and Molecular Epidemiology
  • ISSN: 0003-9926
Paul Franks
E-mail: paul [dot] franks [at] med [dot] lu [dot] se

Principal investigator

Genetic and Molecular Epidemiology

+46 40 39 11 49



Lund University Diabetes Centre, CRC, SUS Malmö, Entrance 72, House 91:12. SE-205 02 Malmö. Telephone: +46 40 39 10 00