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

Acta Diabetol. 2020 May;57(5):527-534. doi: 10.1007/s00592-019-01454-y. Epub 2019 Nov 20.

Abstract

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 HbA1c 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.

Keywords: Diabetic complications; Exercise; Physical activity; Retinopathy; Type 1 diabetes.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Blood Pressure
  • Diabetes Mellitus, Type 1 / complications*
  • Diabetes Mellitus, Type 1 / metabolism
  • Diabetic Retinopathy / epidemiology
  • Diabetic Retinopathy / etiology
  • Diabetic Retinopathy / physiopathology
  • Diabetic Retinopathy / prevention & control*
  • Exercise*
  • Female
  • Finland / epidemiology
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Motor Activity
  • Prospective Studies
  • Risk Reduction Behavior
  • Self Report
  • Surveys and Questionnaires