Physical Activity Reduces Risk of Premature Mortality in Patients With Type 1 Diabetes With and Without Kidney Disease

Tikkanen-Dolenc, Heidi; Wadén, Johan; Forsblom, Carol; Harjutsalo, Valma; Thorn, Lena M.; Saraheimo, Markku; Elonen, Nina; Tikkanen, Heikki; Groop, Per‐Henrik

doi:10.2337/dc17-0615

Cited by 67 publications

(62 citation statements)

References 19 publications

(22 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…128 In T1DM patients, a greater physical activity level is associated with a lower risk of all-cause or cardiovascular mortality. 129 In cardiac patients referred to cardiac rehabilitation presenting diabetes mellitus as a comorbidity, next to the evaluation of the cardiovascular risk profile and glycaemic control in the intake screening, it is recommended to execute a cardiopulmonary exercise test ahead of exercise intervention, regardless of the planned exercise type or intensity, to rule out, or allow treatment of, exercise-induced arterial hypertension and/or silent myocardial ischaemia. [130][131][132] Moreover, clinicians should be aware of the intake/ administration of medications that are associated with elevated risk for hypoglycaemia during or after exercise (e.g.…”

Section: Diabetes Mellitusmentioning

confidence: 99%

Secondary prevention through comprehensive cardiovascular rehabilitation: From knowledge to implementation. 2020 update. A position paper from the Secondary Prevention and Rehabilitation Section of the European Association of Preventive Cardiology

Ambrosetti

Abreu

Corrà

et al. 2020

European Journal of Preventive Cardiology

525

604

View full text Add to dashboard Cite

Secondary prevention through comprehensive cardiac rehabilitation has been recognized as the most cost-effective intervention to ensure favourable outcomes across a wide spectrum of cardiovascular disease, reducing cardiovascular mortality, morbidity and disability, and to increase quality of life. The delivery of a comprehensive and ‘modern’ cardiac rehabilitation programme is mandatory both in the residential and the out-patient setting to ensure expected outcomes. The present position paper aims to update the practical recommendations on the core components and goals of cardiac rehabilitation intervention in different cardiovascular conditions, in order to assist the whole cardiac rehabilitation staff in the design and development of the programmes, and to support healthcare providers, insurers, policy makers and patients in the recognition of the positive nature of cardiac rehabilitation. Starting from the previous position paper published in 2010, this updated document maintains a disease-oriented approach, presenting both well-established and more controversial aspects. Particularly for implementation of the exercise programme, advances in different training modalities were added and new challenging populations were considered. A general table applicable to all cardiovascular conditions and specific tables for each clinical condition have been created for routine practice.

show abstract

Section: Diabetes Mellitusmentioning

confidence: 99%

Secondary prevention through comprehensive cardiovascular rehabilitation: From knowledge to implementation. 2020 update. A position paper from the Secondary Prevention and Rehabilitation Section of the European Association of Preventive Cardiology

Ambrosetti

Abreu

Corrà

et al. 2020

European Journal of Preventive Cardiology

525

604

View full text Add to dashboard Cite

show abstract

“…Furthermore, our group has recently investigated whether exercise amount or intensity influences the risk of premature mortality in patients with type 1 diabetes [ 61 ]. We included 2639 patients, 40.1 ± 12.6 years old, with 23.3 ± 12.8 years of diabetes duration.…”

Section: Physical Activity In Preventing Initiation and Progression Omentioning

confidence: 99%

“…The total amount of self-reported physical activity at baseline was significantly associated with the mortality at follow-up, even after adjusting for sex, smoking, diabetes duration, age of diabetes onset, the presence of diabetic nephropathy, HbA 1c , triglycerides, systolic blood pressure, and BMI. In addition, the relative risk of premature mortality rate was almost doubled in face of low versus moderate/high level of either of exercise components, including intensity, duration or frequency, even after adjustment for sex, diabetes duration, age of diabetes onset, smoking, and nephropathy presence [ 61 ]. Patients with CKD, defined in this study as eGFR below 60 ml/min/1.73m 2 , experienced similar beneficial effects of physical activity on mortality, although when adjusted for the confounders specifically the total amount of leisure time physical activity and exercise frequency were independently associated with all-cause mortality [ 61 ].…”

Section: Physical Activity In Preventing Initiation and Progression Omentioning

confidence: 99%

“…In addition, the relative risk of premature mortality rate was almost doubled in face of low versus moderate/high level of either of exercise components, including intensity, duration or frequency, even after adjustment for sex, diabetes duration, age of diabetes onset, smoking, and nephropathy presence [ 61 ]. Patients with CKD, defined in this study as eGFR below 60 ml/min/1.73m 2 , experienced similar beneficial effects of physical activity on mortality, although when adjusted for the confounders specifically the total amount of leisure time physical activity and exercise frequency were independently associated with all-cause mortality [ 61 ]. Altogether, our results suggest that exercise, in particular a high frequency and high intensity exercise, may reduce the risk of diabetic kidney disease, cardiovascular disease, and mortality in type 1 diabetes.…”

Section: Physical Activity In Preventing Initiation and Progression Omentioning

confidence: 99%

See 1 more Smart Citation

Physical Activity in the Prevention of Development and Progression of Kidney Disease in Type 1 Diabetes

2019

Self Cite

View full text Add to dashboard Cite

Purpose of Review Physical activity is a fundamental part of lifestyle management in diabetes care. Although its benefits are very well recognized in the general population and in people with type 2 diabetes, much less is known about the effects of exercise in type 1 diabetes. In particular, exercise effects in relation to diabetic kidney disease (DKD) are understudied. Some uncertainties about physical activity recommendations stem from the fact that strenuous exercise may worsen albuminuria immediately after the activity. However, in middle-aged and older adults without diabetes, observational studies have suggested that physical activity is associated with a decreased risk of rapid kidney function deterioration. In this review, we focus on the role of physical activity in patients with DKD and type 1 diabetes. Recent Findings Hereby, we present data that show that in individuals at risk of DKD or with established DKD, regular moderate-to-vigorous physical activity was associated with reduced incidence and progression of DKD, as well as reduced risk of cardiovascular events and mortality. Summary Therefore, regular moderate-to-vigorous exercise should become a central part of the management of individuals with type 1 diabetes, in the absence of contraindications and accompanied with all needed educational support for optimal diabetes management.

show abstract

“…Physical activity has been shown to be beneficial for individuals with type 1 diabetes and is associated with reduced risk of cardiovascular disease (CVD) events and premature mortality [1][2][3][4][5][6]. However, studies regarding physical activity and microvascular complications are limited in this patient group.…”

Section: Introductionmentioning

confidence: 99%

Frequent physical activity is associated with reduced risk of severe diabetic retinopathy in type 1 diabetes

et al. 2019

Self Cite

View full text Add to dashboard Cite

Aims The aim of this study was to investigate whether leisure-time physical activity (LTPA) is associated with the development of severe diabetic retinopathy in individuals with type 1 diabetes. Methods Prospective observational analysis as part of the Finnish diabetic nephropathy (FinnDiane) Study with a mean follow-up time of 10.7 years was performed. A total of 1612 individuals with type 1 diabetes were recruited, and LTPA was assessed at baseline using a validated self-report questionnaire. Severe diabetic retinopathy was defined as the initiation of laser treatment due to severe nonproliferative, proliferative retinopathy or diabetic maculopathy (identified from the Care Register for Health Care). Results A total of 261 patients received laser treatment during the follow-up. Higher frequency of LTPA was associated with a lower incidence of severe diabetic retinopathy (p = 0.024), a finding that remained significant after adjustment for gender, duration, age at onset of diabetes, kidney function, BMI, triglycerides and systolic blood pressure. However, when HbA 1c and smoking were added to the Cox regression model the association was no more significant. Conclusions Frequent LTPA is associated with a lower incidence of severe diabetic retinopathy during the follow-up. The total amount or the other components of LTPA (intensity or duration of a single session) were not associated with severe diabetic retinopathy.

show abstract

Physical Activity Reduces Risk of Premature Mortality in Patients With Type 1 Diabetes With and Without Kidney Disease

Abstract: Exercise is associated with a lower risk of premature all-cause and cardiovascular mortality in patients with type 1 diabetes. This study also demonstrates that physical activity is associated with a lower risk of mortality in patients with type 1 diabetes and CKD.

Cited by 67 publications

References 19 publications

Secondary prevention through comprehensive cardiovascular rehabilitation: From knowledge to implementation. 2020 update. A position paper from the Secondary Prevention and Rehabilitation Section of the European Association of Preventive Cardiology

Secondary prevention through comprehensive cardiovascular rehabilitation: From knowledge to implementation. 2020 update. A position paper from the Secondary Prevention and Rehabilitation Section of the European Association of Preventive Cardiology

Physical Activity in the Prevention of Development and Progression of Kidney Disease in Type 1 Diabetes

Frequent physical activity is associated with reduced risk of severe diabetic retinopathy in type 1 diabetes

Contact Info

Product

Resources

About