Frequent exercise best course for type 1 diabetes patients
medwireNews: Frequency may be the strongest physical activity determinant of long-term risk for incident cardiovascular disease (CVD) events in patients with type 1 diabetes, report researchers.
This is in line with current American Diabetes Association recommendations for diabetes patients to spread their weekly exercise over at least 3 days, note Per-Henrik Groop (Folkhälsan Research Center, Helsinki, Finland) and study co-authors.
As reported in Diabetologia, the team studied 2074 type 1 diabetes patients from the prospective, multicenter Finnish Diabetic Nephropathy Study. The patients were aged an average of 38.8 years and had experienced no previous CVD events, but 9.9% did so during an average 10.3 years of follow-up.
Initial analysis showed that their risk for incident CVD events decreased with increasing intensity, frequency, and duration of baseline leisure-time physical activity. For example, the 10-year rates were 15.2% versus 3.3% for low versus high intensity, 14.9% versus 8.3% for low versus high frequency, and 12.6% versus 7.1% for low versus high duration.
All three exercise components remained associated with CVD risk after accounting for gender, duration of diabetes, age at onset of diabetes, and diabetic nephropathy. But the effects of exercise intensity and duration on CVD risk disappeared after accounting for CV risk factors such as body mass index, blood pressure, and glycated hemoglobin levels, implying that the protective effects of these exercise components were accounted for by their beneficial effects on CV risk factors.
However, low versus high exercise frequency remained associated with a significant 69% increase in CVD risk, an unexpected finding, which “suggests that frequent exercise has effects in addition to those of traditional risk factors,” say Groop et al.
The picture was slightly different in a smaller group of 106 patients with pre-existing symptomatic CVD. In these patients, neither the frequency nor the duration of exercise appeared to influence the risk for recurrent CVD events, whereas moderate versus low exercise intensity was associated with a reduced 10-year cumulative risk, of 45.0% versus 68.5%. There were no events in the high-intensity group, but this only comprised two patients.
The researchers caution, however, that their study did not measure work-related activity, leading to the potential underestimation of activity levels in some participants, and that they could not account for changes in the amount of exercise undertaken over follow-up.
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