Impact of Physical Activity on the Incidence of Vascular Diseases in Adults with Type 2 Diabetes Mellitus
AbstractBackground: Diabetes mellitus (DM) is a common metabolic disease worldwide and has many complications. Vascular events are the major complication of DM, which have an important effect on mortality and disability. Physical activity (PA) enhances the vascular function by several pathways. The aim of this study was to evaluate the relationship between PA and vascular diseases in patients with DM. Materials and Methods: This study was performed as a case-control study extracted from a prospective epidemiological research study in Iran. Patients with type 2 DM for more than six months as a case group were compared to sex- and age-matched healthy control subjects. The metabolic equivalent of task score was used to evaluate the level of PA and blood glucose, lipid profile, body mass index, overweight, dyslipidemia, glomerular filtration rate, myocardial infarction, unstable angina, and stroke. Results: Overall, 1242 patients with DM were extracted, and 2484 non-DM subjects were investigated. In the case group, 355 (28.6%) and 887 (71.4%) subjects were men and women, respectively, and 710 (28.6%) men and 1774 (71.4%) women were in the control group. The mean metabolic equivalent of task score was 30 and 40.97 in the DM and non-DM groups, respectively (P˂0.001). The frequency of myocardial infarction, stroke, and cardiac ischemia was 44 (3.5%), 37 (3%), and 267 (21.5%) in the DM group, and 54 (2.2%), 43 (1.7%), and 389 (15.7%) in the non-DM group, respectively. Conclusion: The incidence of vascular events associated with PA level in patients with DM and adherence to regular PA reduced vascular events and DM complications. [GMJ.2019;8:e1549]
Kasper DL, Fauci AS, Hauser SL, Longo DL, Jameson JL, Loscalzo J. Harrison's Principles of Internal Medicine, (Vol. 1 & Vol. 2). McGraw Hill Professional; 2018.
Ogurtsova K, da Rocha Fernandes JD, Huang Y, Linnenkamp U, Guariguata L, Cho NH et al. IDF Diabetes Atlas: Global estimates for the prevalence of diabetes for 2015 and 2040. Diabetes Research and Clinical Practice. 2017;128:40-50. doi:10.1016/j.diabres.2017.03.024.
Association AD. Standards of Medical Care in Diabetes-2019 abridged for primary care providers. Clinical Diabetes. 2019;37(1):11-34.
Yozgatli K, Lefrandt JD, Noordzij MJ, Oomen PHN, Brouwer T, Jager J et al. Accumulation of advanced glycation end products is associated with macrovascular events and glycaemic control with microvascular complications in Type 2 diabetes mellitus. Diabetic Medicine. 2018. doi:10.1111/dme.13651.
Cavalot F, Petrelli A, Traversa M, Bonomo K, Fiora E, Conti M et al. Postprandial blood glucose is a stronger predictor of cardiovascular events than fasting blood glucose in type 2 diabetes mellitus, particularly in women: lessons from the San Luigi Gonzaga Diabetes Study. The Journal of Clinical Endocrinology & Metabolism. 2006;91(3):813-9.
Turner R, Millns H, Neil H, Stratton I, Manley S, Matthews D et al. Risk factors for coronary artery disease in non-insulin dependent diabetes mellitus: United Kingdom Prospective Diabetes Study (UKPDS: 23). BMJ. 1998;316(7134):823-8.
Roberts CK, Hevener AL, Barnard RJ. Metabolic syndrome and insulin resistance: underlying causes and modification by exercise training. Comprehensive Physiology. 2013;3(1):1-58.
Wang X, Patterson BW, Smith GI, Kampelman J, Reeds DN, Sullivan SA et al. A∼ 60-min brisk walk increases insulin-stimulated glucose disposal but has no effect on hepatic and adipose tissue insulin sensitivity in older women. Journal of applied physiology. 2013;114(11):1563-8.
Wojtaszewski JF, Nielsen JN, Richter EA. Invited review: effect of acute exercise on insulin signaling and action in humans. Journal of applied physiology. 2002;93(1):384-92.
Hawley JA, Lessard S. Exercise training‐induced improvements in insulin action. Acta physiologica. 2008;192(1):127-35.
Umpierre D, Ribeiro PA, Kramer CK, Leitao CB, Zucatti AT, Azevedo MJ et al. Physical activity advice only or structured exercise training and association with HbA1c levels in type 2 diabetes: a systematic review and meta-analysis. JAMA. 2011;305(17):1790-9. doi:10.1001/jama.2011.576.
Bohn B, Herbst A, Pfeifer M, Krakow D, Zimny S, Kopp F et al. Impact of Physical Activity on Glycemic Control and Prevalence of Cardiovascular Risk Factors in Adults With Type 1 Diabetes: A Cross-sectional Multicenter Study of 18,028 Patients. Diabetes Care. 2015;38(8):1536-43. doi:10.2337/dc15-0030.
Chudyk A, Petrella RJ. Effects of exercise on cardiovascular risk factors in type 2 diabetes: a meta-analysis. Diabetes Care. 2011;34(5):1228-37. doi:10.2337/dc10-1881.
Association AD. 8. Cardiovascular disease and risk management. Diabetes care. 2016;39(Supplement 1):S60-S71.
Farjam M, Bahrami H, Bahramali E, Jamshidi J, Askari A, Zakeri H et al. A cohort study protocol to analyze the predisposing factors to common chronic non-communicable diseases in rural areas: Fasa Cohort Study. BMC Public Health. 2016;16(1):1090.
Eghtesad S, Mohammadi Z, Shayanrad A, Faramarzi E, Joukar F, Hamzeh B et al. The PERSIAN cohort: Providing the evidence needed for healthcare reform. Archives of Iranian medicine. 2017:291-5.
Ainsworth BE, Haskell WL, Leon AS, Jacobs JD, Montoye HJ, Sallis JF et al. Compendium of physical activities: classification of energy costs of human physical activities. Medicine and science in sports and exercise. 1993;25(1):71-80.
Moghaddam MB, Aghdam FB, Jafarabadi MA, Allahverdipour H, Nikookheslat SD, Safarpour S. The Iranian Version of International Physical Activity Questionnaire (IPAQ) in Iran: content and construct validity, factor structure, internal consistency and stability. World applied sciences journal. 2012;18(8):1073-80.
Whelton PK, Carey RM, Aronow WS, Casey DE, Jr., Collins KJ, Dennison Himmelfarb C et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2018;71(19):e127-e248. doi:10.1016/j.jacc.2017.11.006.
Compean-Ortiz LG, Trujillo-Olivera LE, Valles-Medina AM, Resendiz-Gonzalez E, Garcia-Solano B, Perez BDA. Obesity, physical activity and prediabetes in adult children of people with diabetes. Rev Lat Am Enfermagem. 2018;25:e2981. doi:10.1590/1518-8345.2102.2981.
Bishwajit G, Yaya S, Seydou I. Diabetes mellitus and high blood pressure in relation to BMI among adult non-pregnant women in Bangladesh. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2017;11 Suppl 1:S217-S21. doi:10.1016/j.dsx.2016.12.034.
Lee J-H, Lee R, Hwang M-H, Hamilton MT, Park Y. The effects of exercise on vascular endothelial function in type 2 diabetes: a systematic review and meta-analysis. Diabetology & metabolic syndrome. 2018;10(1):15.
Hwang MH, Kim S. Type 2 Diabetes: Endothelial dysfunction and Exercise. J Exerc Nutrition Biochem. 2014;18(3):239-47. doi:10.5717/jenb.2014.18.3.239.
Di Francescomarino S, Sciartilli A, Di Valerio V, Di Baldassarre A, Gallina S. The effect of physical exercise on endothelial function. Sports Med. 2009;39(10):797-812. doi:10.2165/11317750-000000000-00000.
Chen Y, Sloan FA, Yashkin AP. Adherence to diabetes guidelines for screening, physical activity and medication and onset of complications and death. J Diabetes Complications. 2015;29(8):1228-33. doi:10.1016/j.jdiacomp.2015.07.005.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution 4.0 International License that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).