Effect of physical activity on reducing the risk of diabetic retinopathy progression: 10-year prospective findings from the 45 and Up Study

Abstract

Objective To examine the association of physical activities (PA) with diabetic retinopathy (DR) progression based on a 10-year follow-up of a large cohort of working-aged diabetic populations in Australia. Methods Nine thousand and eighteen working-aged diabetic patients were enrolled from the baseline of the 45 and Up Study from New South Wales, Australia. Self-reported PA collected by questionnaire at baseline in 2006 was graded into low (<5 sessions/week), medium (≥5–14), and high (≥14) levels. Retinal photocoagulation (RPC) treatment during the follow-up period was used as a surrogate for DR progression and was tracked through the Medicare Benefits Schedule, which was available from 2004 to 2016. Cox regression was used to estimate the association between PA and RPC incidence. Results In the fully adjusted model, higher PA level was significantly associated with a lower risk of RPC incident (Cox-regression, p-value for trend = 0.002; medium vs. low, hazard ratio (HR) = 0.78, 95% Confidence Interval (CI): 0.61–0.98; high vs. low, HR = 0.61, 95%CI: 0.36–0.84. In addition, gender, body mass index, insulin treatment, family history of diabetes, history of cardiovascular disease were significant effect modifiers for the association between PA and RPC. Conclusions Higher PA level was independently associated with a lower risk of DR progression among working-aged diabetic populations in this large cohort study.

Diabetic retinopathy as the leading cause of blindness and early predictor of cascading complications—risks and mitigation

“…Another study indicated that frequent leisure-time physical activity reduced the severity of DR after adjusting for gender, duration, age at onset of diabetes, kidney function, triglycerides, systolic blood pressure, and BMI [ 112 ]. Yan et al have shown that physical activity was related to decreased risk of retinal photocoagulation as well as DR progression in the Australian population of working-aged diabetic patients [ 113 ]. Association between physical activity and DR is influenced by various modifiers, including BMI, gender, history of CVD, diabetes (in family), and insulin therapy [ 113 ].…”

Associations Among Outdoor Time, Skin Tanning, and the Risk of Surgically Treated Cataract for Australians 45 to 65 Years of Age

“…Detailed study methods have been described in earlier studies. 14 , 15 The conduct of the 45 and Up Study was approved by the University of New South Wales Human Research Ethics Committee. The study protocol was approved by the Royal Victorian Eye and Ear Hospital Human Research Ethics Committee (17/1330HS/20).…”

The Effect of Diet and Lifestyle on the Course of Diabetic Retinopathy—A Review of the Literature

“…Increasing physical activity reduces the risk of developing diabetic retinopathy [ 80 , 81 ]. Kuwata et al showed that higher levels of physical activity were independently associated with a lower incidence of DR in patients with type 2 diabetes [ 82 ].…”