Leisure-time physical activity and risk of microvascular complications in individuals with type 2 diabetes: A UK Biobank study
Published version of a preprint
Abstract
OBJECTIVE: The aim of this study was to determine dose-response associations, including the minimal effective level, between leisure-time physical activity and risk of incident neuropathy, nephropathy, and retinopathy. RESEARCH DESIGN AND METHODS: This cohort study included 18,092 individuals with type 2 diabetes from the UK Biobank. Self-reported leisure-time physical activity was converted into MET-hours per week. Participants were categorized into no physical activity (0 MET-h/week), below recommendations (0-7.49 MET-h/week), at recommendations (7.5-14.9 MET-h/week), and above recommendations (≥15 MET-h/week). Microvascular complications were identified from hospital inpatient records using diagnosis codes. We used Cox proportional hazards regression analysis to calculate adjusted hazard ratios (aHRs) and restricted cubic splines to identify the minimal effective level of physical activity. RESULTS: During a median follow-up of 12.1 years, 672 individuals (3.7%) were diagnosed with neuropathy, 1,839 (10.2%) with nephropathy, and 2,099 (11.7%) with retinopathy. Any level of physical activity was associated with a lower risk of neuropathy and nephropathy but not retinopathy. Compared with those reporting no physical activity, the aHR of neuropathy was 0.71 (95% CI 0.53, 0.90) below recommendations, 0.73 (0.56, 0.96) at recommendations, and 0.67 (0.52, 0.87) above recommendations. Corresponding aHRs for nephropathy were 0.79 (0.68, 0.92), 0.80 (0.67, 0.95), and 0.80 (0.68, 0.95). The association with retinopathy was weaker, with aHRs of 0.91 (0.78, 1.06), 0.91 (0.77, 1.08), and 0.98 (0.84, 1.15), respectively. CONCLUSIONS: Any level of leisure-time physical activity was associated with a lower risk of neuropathy and nephropathy but not retinopathy in individuals with type 2 diabetes. For both neuropathy and nephropathy, the minimal effective physical activity level may correspond to <1.5 h of walking per week.
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A recent UK Biobank study reported that self-reported total leisure-time physical activity lowered risk of developing microvascular events in individuals with type 2 diabetes mellitus by 20%-30%.
“a recent study by the UK Biobank supported our finding, reporting that self-reported total leisure-time PA lowered the risk of developing microvascular events in individuals with T2DM by 20%–30%;7”
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- Authors
- Kristensen, F. P. B., Sanchez-Lastra, M. A., Dalene, K. E., del Pozo Cruz, B., Ried-Larsen, M., Thomsen, R. W., Ding, D., Ekelund, U., & Tarp, J.
- Affiliations
- Aarhus University (DK)
- 2Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
- Norwegian Institute of Public Health (NO)
- 6Centre for Active and Healthy Ageing, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- 9Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- The University of Sydney (AU)
- Corresponding author
- Kristensen, Frederik Pagh Bredahl
- ORCID
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2023-08-07
- Volume
- 46
- Issue
- 10
- Pages
- 1816-1824
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W4385622205
- Cited by
- 29
- References
- 39
- Citations by year
- 2026: 9 · 2025: 12 · 2024: 7 · 2023: 1
- FWCI
- 5.12
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- University of Southern Denmark Research Portal (University of Southern Denmark) (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- leisure-time physical activity, type 2 diabetes, microvascular complications, diabetic neuropathy, diabetic nephropathy, diabetic retinopathy, dose-response relationship, MET-hours per week, physical activity guidelines, risk mitigation, UK Biobank, inpatient medical records, restricted cubic splines, mortality risk, cancer risk
- MeSH terms
- Diabetes Mellitus, Type 2, United Kingdom, Humans, Leisure Activities, Risk Factors, Cohort Studies, Biological Specimen Banks
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