Effects of Physical Activity on Type 2 Diabetes Incidence and Mortality

A study reported nearly three decades of data on the correlation between moderate and vigorous physical activity and type 2 diabetes incidence, as well as how physical activity post-diabetes diagnosis affects all-cause and cardiovascular disease (CVD) mortality risks. The Whitehall II cohort study included 9,987 patients recruited between 1985 and 1988 who did not have type 2 diabetes at baseline. Patients were followed for incident type 2 diabetes, which was confirmed per clinical assessments through 2016 and linked electronic health records through March 31, 2017. The association between moderate and physical activity and incident type 2 diabetes was first analyzed per a survey between 1985 and 1988; mean patient age at this time was 44.9 years, and 32.7% were women. The second analysis included patients who developed type 2 diabetes during follow-up and calculated the association of moderate-to-vigorous physical activity after disease diagnosis with risk of all-cause and CVD mortality. Mean follow-up was 27.1 years, during which 1,553 patients developed type 2 diabetes. Patients who engaged in any duration of moderate-to-vigorous physical activity during the first part of the study were less likely to develop type 2 diabetes (hazard ratio [HR], 0.85; 95% confidence interval [CI], 0.75-0.97; P=0.02). Moderate-to-vigorous physical activity data were available for 1,026 patients diagnosed with type 2 diabetes; during a mean follow-up of 8.8 years, 165 all-cause and 55 CVD-related deaths occurred. Among patients with type 2 diabetes, any duration of moderate-to-vigorous physical activity reduced the risk of all-cause mortality (HR, 0.61; 95% CI, 0.41-0.93; P=0.02); CVD-related mortality was only reduced among patients who engaged in at least 2.5 hours per week of moderate-to-vigorous physical activity or at least 1.25 hours per week of vigorous physical activity (HR, 0.40; 95% CI, 0.16-0.96; P=0.04).