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. 2025 Oct 9;25(1):3431.
doi: 10.1186/s12889-025-24662-4.

Association between device-measured physical activities, type 2 diabetes, and life expectancy over the next 10 years: a prospective longitudinal study

Ziqiang Lin #  1 , Jiade Chen #  1 , Yutai Cai  1 , Zhehao Wang  1 , Jing Xu  1 , Yingying Shi  1 , Jiawei Li  1 , Peng Xu  2 , Jiaxin Shen  1 , Guanren Chen  1 , Qingguang Zhong  1 , Tao Zhang  1 , Qiaoman Mo  1 , Qiaoxuan Lin  3 , Jiale Bu  1 , Pengqing Sun  1 , Lixia Li  2 , Fan Zhang  4 , Yanhui Gao  5   6
Affiliations

Association between device-measured physical activities, type 2 diabetes, and life expectancy over the next 10 years: a prospective longitudinal study

Ziqiang Lin et al. BMC Public Health. .

Abstract

Background: The mediation effect of 24-hour physical activities on the association between type 2 diabetes and mortality is unclear. Additionally, Little evidence was found on the isotemporal substitution effect of 24-hour physical activities components on changing Life expectancy among patients with type 2 diabetes diagnosed. To address the abovementioned research gap, the study has a two-fold aims: first, to examine the mediation effect of 24-hour physical activities in type 2 diabetes and mortality; and second, to address how reallocating time on different daily activities would affect life expectancy.

Methods: Analysis was conducted on the accelerometer data of 103,359 participants in the UK Biobank, with a median age of 57 years (range 39 to 70). Compositional mediation cox model was conducted to analyze the mediating effects of 24-hour physical activities. Additionally, the cohort Life table method was utilized to estimate the changes of Life-years over the next 10 years resulting from the substitution effect of different physical activities.

Results: During a mean follow-up of 13.95 (range 2.95-16.28) years, 2,649 deaths were recorded. Diabetes was significantly associated with increased time spent engaging in sedentary behavior (SB), and reduced time spent on moderate-to-vigorous physical activity (MVPA) and light-intensive physical activity (LPA), thereby demonstrating an association with higher mortality risk. The indirect effect of physical activity (HR = 1.27, 95% CI 1.23-1.30) accounted for 41.9% of the total effect of diabetes on mortality. Furthermore, the Life expectancy gains with a maximum of 1.32 years over the next 10 years was found when reallocating SB time to MVPA.

Conclusion: The results revealed that 24-hour physical activities might mediate the association between diabetes and mortality. Therefore, promoting participation in MVPA and reducing sedentary activities among diabetes patients was expected to have a positive effect on Life expectancy over the next 10 years.

Keywords: Diabetes; Life expectancy; Physical activity; Prospective longitudinal study.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: All procedures involving human participants in this study adhered to the ethical principles outlined in the Declaration of Helsinki (1964) and its later revisions. Ethical approval for the UK Biobank was granted by the North West Multicentre Research Ethics Committee (REC reference: 21/NW/0157). Written informed consent was obtained from all individuals at the time of enrollment. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
presents the coefficient of diabetes to mortality mediated by daily engagement in physical activity using compositional mediation model. Model adjusted for age, gender, ethnicity, BMI, smoking status, drinking status, and education.
Fig. 2
Fig. 2
Expected hazard ratios based on the proportional cox model with diabetes participants against daily time (in minutes) spent in A: Moderate-to-vigorous physical activity (MVPA); and B: Sedentary behavior (SB). Time is exchanged between the component on the X-axis and the remaining components. Model adjusted for age, gender, ethnicity, BMI, smoking status, drinking status, and education.
Fig. 3
Fig. 3
.Expected life gain in the upcoming decade from a). Replacing remaining time to MVPA and b). Replacing remaining time to SB
See this image and copyright information in PMC

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