Diabetes Metab J.  2022 Mar;46(2):327-336. 10.4093/dmj.2021.0046.

Changes in Patterns of Physical Activity and Risk of Heart Failure in Newly Diagnosed Diabetes Mellitus Patients

• Jung I
• Kwon H
• Park SE
• Han KD
• Park YG
• Rhee EJ
• Lee WY

• KMID: 2527725
• DOI: http://doi.org/10.4093/dmj.2021.0046

Abstract

Background
Exercise is recommended for type 2 diabetes mellitus (T2DM) patients to prevent cardiovascular disease. However, the effects of physical activity (PA) for reducing the risk of heart failure (HF) has yet to be elucidated. We aimed to assess the effect of changes in patterns of PA on incident HF, especially in newly diagnosed diabetic patients.
Methods
We examined health examination data and claims records of 294,528 participants from the Korean National Health Insurance Service who underwent health examinations between 2009 and 2012 and were newly diagnosed with T2DM. Participants were classified into the four groups according to changes in PA between before and after the diagnosis of T2DM: continuously inactive, inactive to active, active to inactive, and continuously active. The development of HF was analyzed until 2017.
Results
As compared with those who were continuously inactive, those who became physically active after diagnosis showed a reduced risk for HF (adjusted hazard ratio [aHR], 0.79; 95% confidence interval [CI], 0.66 to 0.93). Those who were continuously active had the lowest risk for HF (aHR, 0.77; 95% CI, 0.62 to 0.96). As compared with those who were inactive, those who exercised regularly, either performing vigorous or moderate PA, had a lower HF risk (aHR, 0.79; 95% CI, 0.69 to 0.91).
Conclusion
Among individuals with newly diagnosed T2DM, the risk of HF was reduced in those with higher levels of PA after diagnosis was made. Our results suggest either increasing or maintaining the frequency of PA after the diagnosis of T2DM may lower the risk of HF.

Keyword

Diabetes mellitus; Exercise; Heart failure; Physical activity

Figure

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  Fig. 1. Hazard ratio for incident heart failure (HF) according to changes in the pattern of physical activity. Cox proportional-hazards regression analysis was adopted and we calculated the hazard ratio and 95% confidence interval for incident HF according to changes in the pattern of physical activity. Adjusted for age, sex, current smoking, alcohol, income, waist circumference, hypertension, dyslipidemia, chronic kidney disease, stroke, myocardial infarction, and fasting blood glucose. CI, confidence interval.

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