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12-24-2016 | Physical activity | Article

Frequent and intensive physical activity reduces risk of cardiovascular events in type 1 diabetes

Journal: Diabetologia

Authors: Heidi Tikkanen-Dolenc, Johan Wadén, Carol Forsblom, Valma Harjutsalo, Lena M. Thorn, Markku Saraheimo, Nina Elonen, Milla Rosengård-Bärlund, Daniel Gordin, Heikki O. Tikkanen, Per-Henrik Groop, on behalf of the FinnDiane Study Group

Publisher: Springer Berlin Heidelberg

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Abstract

Aims/hypothesis

Cardiovascular disease (CVD) is the most common cause of premature death and disability among patients with type 1 diabetes. Diabetic nephropathy accounts for the increased cardiovascular morbidity and mortality of these patients. We recently showed that the intensity of exercise predicts the incidence and progression of diabetic nephropathy in patients with type 1 diabetes. Little is known about the relationship between physical activity and CVD. Therefore, we studied how physical activity affects the risk of CVD events in patients with type 1 diabetes.

Methods

A 10 year follow-up study including 2180 type 1 diabetes patients from the nationwide multicentre Finnish Diabetic Nephropathy Study (FinnDiane). Leisure time physical activity (LTPA) was assessed by a previously validated self-report questionnaire. A CVD event was defined as a verified myocardial infarction, coronary procedure or stroke. Patients were analysed separately for the risk of developing a first ever CVD event and for the risk of a recurrent CVD event following a baseline event.

Results

A total of 206 patients had an incident CVD event during follow-up. A higher total LTPA and higher intensity, frequency and duration of activity were associated with a lower risk of incident CVD events. The observed association between exercise frequency and incident CVD remained significant when adjusted for classic risk factors. Exercise intensity also had a borderline effect on the recurrence-free time in patients with a major CVD event at baseline.

Conclusions/interpretation

This study suggests that exercise, particularly high frequency and high intensity exercise, may reduce the risk of CVD events in patients with type 1 diabetes.
Literature
1.
Morrish NJ, Wang SL, Stevens LK et al (2001) Mortality and causes of death in the WHO multinational study of vascular disease in diabetes. Diabetologia 44:14–21 CrossRef
2.
Wadén J, Forsblom C, Thorn LM et al (2008) Physical activity and diabetes complications in patients with type 1 diabetes: the Finnish Diabetic Nephropathy (FinnDiane) Study. Diabetes Care 31:230–232 CrossRefPubMed
3.
Kriska AM, LaPorte RE, Patrick SL, Kuller LH, Orchard TJ (1991) The association of physical activity and diabetic complications in individuals with insulin-dependent diabetes mellitus: the Epidemiology of Diabetes Complications Study – VII. J Clin Epidemiol 44:1207–1214 CrossRefPubMed
4.
Dorman J, Laporte R, Kuller L et al (1984) The Pittsburgh insulin-dependent diabetes mellitus (IDDM) morbidity and mortality study: mortality results. Diabetes 33:271–276 CrossRefPubMed
5.
Tielemans S, Soedamah-Muthu S, De Neve M et al (2013) Association of physical activity with all-cause mortality and incident and prevalent cardiovascular disease among patients with type 1 diabetes: the EURODIAB prospective complications study. Diabetologia 56:82–91 CrossRefPubMed
6.
Groop PH, Thomas MC, Moran JL et al (2009) The presence and severity of chronic kidney disease predicts all-cause mortality in type 1 diabetes. Diabetes 58:1651–1658 CrossRefPubMedPubMedCentral
7.
Wadén J, Tikkanen HK, Forsblom C et al (2015) Leisure-time physical activity and development and progression of diabetic nephropathy in type 1 diabetes: the FinnDiane study. Diabetologia 58:929–936 CrossRefPubMed
8.
Libby P, Nathan DM, Abraham K et al (2005) Report of the national heart, lung, and blood institute-national institute of diabetes and digestive and kidney diseases working group on cardiovascular complications of type 1 diabetes mellitus. Circulation 111:3489–3493 CrossRefPubMed
9.
Wadén J, Tikkanen H, Forsblom C et al (2005) Leisure time physical activity is associated with poor glycemic control in type 1 diabetic women: the FinnDiane study. Diabetes Care 28:777–782 CrossRefPubMed
10.
Lakka T, Salonen J (1992) Intra-person variability of various physical activity assessments in the kuopio ischaemic heart disease risk factor study. Int J Epidemiol 21:467–472 CrossRefPubMed
11.
Salonen J, Lakka T (1987) Assessment of physical activity in population studies: validity and consistency of the methods in the Kuopio ischemic heart disease risk factor study. Scand J Sports Sci 9:89–95
12.
Sund R (2012) Quality of the Finnish hospital discharge register: a systematic review. Scand J Public Health 40:505–515 CrossRefPubMed
13.
Babraj J, Vollaard N, Keast C, Guppy F, Cottrell G, Timmons J (2009) Extremely short duration high intensity interval training substantially improves insulin action in young healthy males. BMC Endocr Disord 9:3 CrossRefPubMedPubMedCentral
14.
Dunstan DW, Daly RM, Owen N et al (2002) High-intensity resistance training improves glycemic control in older patients with type 2 diabetes. Diabetes Care 25:1729–1736 CrossRefPubMed
15.
Lee IM, Sesso HD, Oguma Y, Paffenbarger RS Jr (2003) Relative intensity of physical activity and risk of coronary heart disease. Circulation 107:1110–1116 CrossRefPubMed
16.
Tjønna AE, Lee SJ, Rognmo Ø et al (2008) Aerobic interval training versus continuous moderate exercise as a treatment for the metabolic syndrome. Circulation 118:346–354 CrossRefPubMedPubMedCentral
17.
Tremblay A, Després JP, Leblanc C et al (1990) Effect of intensity of physical activity on body fatness and fat distribution. Am J Clin Nutr 51:153–157 PubMed
18.
Paffenbarger RS Jr, Lee IM (1997) Intensity of physical activity related to incidence of hypertension and all-cause mortality: an epidemiological view. Blood Press Monit 2:115 PubMed
19.
Hu FB, Sigal RJ, Rich-Edwards JW et al (1999) Walking compared with vigorous physical activity and risk of type 2 diabetes in women. JAMA 282:1433–1439 CrossRefPubMed
20.
Tanasescu M, Leitzmann MF, Rimm EB, Willett WC, Stampfer MJ, Hu FB (2002) Exercise type and intensity in relation to coronary heart disease in men. JAMA 288:1994–2000 CrossRefPubMed
21.
Lee IM, Hsieh C, Paffenbarger RS Jr (1995) Exercise intensity and longevity in men. JAMA 273:1179–1184 CrossRefPubMed
22.
Chimen M, Kennedy A, Nirantharakumar K, Pang TT, Andrews R, Narendran P (2012) What are the health benefits of physical activity in type 1 diabetes mellitus? A literature review. Diabetologia 55:542–551 CrossRefPubMed
23.
Saraheimo M, Teppo AM, Forsblom C, Fagerudd J, Groop PH (2003) Diabetic nephropathy is associated with low-grade inflammation in type 1 diabetic patients. Diabetologia 46:1402–1407 CrossRefPubMed

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