All-cause and cardiovascular mortality risk in U.S. adults with and without type 2 diabetes: Influence of physical activity, pharmacological treatment and glycemic control

Abstract

Aims: This study determined the joint association between physical activity, pharmacotherapy, and HbA1c control on all-cause and cardiovascular disease (CVD) mortality risk in adults with and without type 2 diabetes (T2D).

Methods: 12,060 adults from NHANES III and NHANES continuous (1999-2002) surveys were used. Cox proportional hazards analyses were included to estimate mortality risk according to physical activity, pharmacotherapy, and glycemic control (HbA1c <7.0%) status, with physically active, treated and controlled (goal situation) as the referent.

Results: Compared to the referent, adults with T2D who were uncontrolled, or controlled but physically inactive had a higher all-cause mortality risk (p<0.05). Compared to the referent, only adults with T2D who were physically inactive had a higher CVD mortality risk, regardless of treatment or control status (p<0.05). Normoglycemic adults had a similar all-cause and CVD mortality risk as the referent (p>0.05).

Conclusions: Physical activity and glycemic control are both associated with lower all-cause and CVD mortality risk in adults with T2D. Adults with T2D who are physically active, pharmacologically treated, and obtain glycemic control may attain similar mortality risk as normoglycemic adults.

Keywords: HbA1c; Leisure Activities; NHANES; Type 2 diabetes mellitus.