Association of a Healthy Lifestyle With All-Cause and Cause-Specific Mortality Among Individuals With Type 2 Diabetes: A Prospective Study in UK Biobank
Published version of a preprint
Abstract
OBJECTIVE: To evaluate the association of a healthy lifestyle, involving seven low-risk factors mentioned in diabetes management guidelines (no current smoking, moderate alcohol consumption, regular physical activity, healthy diet, less sedentary behavior, adequate sleep duration, and appropriate social connection), with all-cause and cause-specific mortality among individuals with type 2 diabetes. RESEARCH DESIGN AND METHODS: This study included 13,366 participants with baseline type 2 diabetes from the UK Biobank free of cardiovascular disease (CVD) and cancer. Lifestyle information was collected through a baseline questionnaire. RESULTS: During a median follow-up of 11.7 years, 1,561 deaths were documented, with 625 from cancer, 370 from CVD, 115 from respiratory disease, 81 from digestive disease, and 74 from neurodegenerative disease. In multivariate-adjusted model, each lifestyle factor was significantly associated with all-cause mortality, and hazard ratios associated with the lifestyle score (scoring 6–7 vs. 0–2 unless specified) were 0.42 (95% CI 0.34, 0.52) for all-cause mortality, 0.57 (0.41, 0.80) for cancer mortality, 0.35 (0.22, 0.56) for CVD mortality, 0.26 (0.10, 0.63) for respiratory mortality, and 0.28 (0.14, 0.53) for digestive mortality (scoring 5–7 vs. 0–2). In the population-attributable risk analysis, 29.4% (95% CI 17.9%, 40.9%) of deaths were attributable to a poor lifestyle (scoring 0–5). The association between a healthy lifestyle and all-cause mortality was consistent, irrespective of factors reflecting diabetes severity (diabetes duration, glycemic control, diabetes-related microvascular disease, and diabetes medication). CONCLUSIONS: A healthy lifestyle was associated with a lower risk of all-cause mortality and mortality due to CVD, cancer, respiratory disease, and digestive disease among individuals with type 2 diabetes.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Some prospective cohort studies reported that ≥150 min/week of moderate-to-vigorous-intensity physical activity or ≥75 min/week of vigorous-intensity physical activity was associated with 14%-37% lower risks of all-cause mortality in diabetic adults.
“Moreover, some prospective cohort studies reported that ≥150 min/week of moderate-to-vigorous-intensity PA (MVPA) or ≥75 min/week of vigorous-intensity PA (VPA) was associated with 14%–37% lower risks of all-cause mortality in diabetic adults8–10.”
From Accelerometer-derived physical activity and mortality in individuals with type 2 diabetes (2024) · cites this paper as [9]
The algorithms for the capture and adjudication of prevalent T2D was consistent with previous research.
“The algorithms for the capture and adjudication of prevalent T2D was consistent with previous research9.”
From Accelerometer-derived physical activity and mortality in individuals with type 2 diabetes (2024) · cites this paper as [9]
The citation lists haven’t been fetched yet
References 40 · Cited by 290
- Authors
- Han, H., Cao, Y., Feng, C., Zheng, Y., Dhana, K., Zhu, S., Shang, C., Yuan, C., & Zong, G.
- Affiliations
- Shanghai Institute of Nutrition and Health (CN)
- Fudan University (CN)
- Rush University Medical Center (US)
- University of Science and Technology of China (CN)
- Harvard University (US)
- Shanghai Jiao Tong University (CN)
- Corresponding author
- Zong, Geng
- ORCID
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2021-12-02
- Volume
- 45
- Issue
- 2
- Pages
- 319-329
- ISSN
- 0149-5992 (ISSN-L)
- OpenAlex
- W3215866497
- Cited by
- 290
- References
- 40
- Citations by year
- 2026: 49 · 2025: 84 · 2024: 92 · 2023: 57 · 2022: 8
- FWCI
- 29.56
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Medical Research Council (MC_PC_17228)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Health Professions › General Health Professions › Health and Lifestyle Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Keywords
- type 2 diabetes, healthy lifestyle, all-cause mortality, cause-specific mortality, cancer mortality, cardiovascular mortality, respiratory mortality, physical activity, alcohol consumption, smoking, sedentary behavior, sleep duration, social connectedness, lifestyle score, population attributable risk
- MeSH terms
- Healthy Lifestyle, Cardiovascular Diseases, Cause of Death, Diabetes Mellitus, Type 2, United Kingdom, Humans, Life Style, Prospective Studies, Risk Factors, Biological Specimen Banks, Neurodegenerative Diseases
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
