Cycling lowers risk of premature mortality in diabetes patients: JAMA
Denmark: Cycling is associated with a lower risk of all-cause and CVD mortality in diabetes patients independent of other types of physical activity, recent research in JAMA Internal Medicine has revealed. People who took up cycling had a considerably lower risk of both all-cause and CVD mortality than noncyclists.
The findings suggest that cycling should be encouraged as an activity in diabetics for lowering the risk of premature mortality.
Diabetes patients are at a higher risk of premature death from all causes and cardiovascular disease (CVD). Previous studies have shown regular physical activity to be a critical behavioral target for diabetes management. Only structured exercise, in contrast with advice only, has been shown to improve CVD risk factors. In lieu of this, it becomes important to investigate the influence of engagement in specific unstructured physical activities on mortality in this patient population.
Considering the above, Mathias Ried-Larsen, Centre for Physical Activity Research, Rigshospitalet, Copenhagen, Denmark, and colleagues set out to investigate the association between time spent cycling and all-cause and CVD mortality among persons with diabetes, as well as to evaluate the association between change in time spent cycling and risk of all-cause and CVD mortality.
For this purpose, the researchers conducted a prospective cohort study and included 7459 adults with diabetes from the European Prospective Investigation into Cancer and Nutrition study. Questionnaires regarding medical history, sociodemographic, and lifestyle information were administered in 10 Western European countries from 1992 through 2000 (baseline examination) and at a second examination 5 years after baseline.
A total of 5423 participants with diabetes completed both examinations. The final updated primary analysis was conducted on November 13, 2020.
The primary exposure was self-reported time spent cycling per week at the baseline examination. The secondary exposure was change in cycling status from baseline to the second examination.
The primary and secondary outcomes were all-cause and CVD mortality, respectively, adjusted for other physical activity modalities, diabetes duration, and sociodemographic and lifestyle factors.
Of the 7459 adults with diabetes included in the analysis, the mean age was 55.9 years, and 3924 (52.6%) were female. During 110 944 person-years of follow-up, 1673 deaths from all causes were registered.
Based on the research, the researchers found the following:
- Compared with the reference group of people who reported no cycling at baseline (0 min/wk), the multivariable-adjusted hazard ratios for all-cause mortality were 0.78, 0.76, 0.68, and 0.76 for cycling 1 to 59, 60 to 149, 150 to 299, and 300 or more min/wk, respectively.
- In an analysis of change in time spent cycling with 57 802 person-years of follow-up, a total of 975 deaths from all causes were recorded.
- Compared with people who reported no cycling at both examinations, the multivariable-adjusted hazard ratios for all-cause mortality were 0.90 in those who cycled and then stopped, 0.65 in initial noncyclists who started cycling, and 0.65 for people who reported cycling at both examinations. Similar results were observed for CVD mortality.
"After considering other physical activities as well as other risk factors, the results of this cohort study showed that engaging in cycling was associated with a lower risk of all-cause and CVD mortality among people with diabetes," wrote the authors. "Studies with repeated measurement of cycling and documentation of cycling-related accidents are needed to elaborate on the dose-response relationship between cycling and mortality."
The study titled, "Association of Cycling With All-Cause and Cardiovascular Disease Mortality Among Persons With Diabetes: The European Prospective Investigation Into Cancer and Nutrition (EPIC) Study," is published in JAMA Internal Medicine.