Cycling may prevent deaths in diabetes patients

Cycling was associated with reduced risk for both all-cause and cardiovascular (CV) mortality in people with diabetes, according to a study presented at EASD 2020 Meeting — suggesting that cycling could be encouraged as an activity to prevent deaths in this population who are known to have a higher mortality risk than the general public.

“These findings suggest that cycling could be considered as an addition to existing physical activity referral schemes to increase physical activity in the clinical care of diabetes,” said presenting author Dr Mathias Ried-Larsen from the Centre for Physical Activity Research, Rigshospitalet in Copenhagen, Denmark.

In the prospective cohort study, 5,506 adults with self-reported diabetes across eight Western European countries were surveyed on their cycling habits at baseline and followed up with a second survey 5 years later. [EASD 2020, abstract 194]

“[One of the reasons cycling was the focus is that] cycling is the candidate activity to replace motorized transport over short distances,” explained Ried-Larsen.

Compared with the people who did not cycle at baseline, the risk of all-cause mortality was significantly lower by 25 percent, 24 percent, 31 percent, and 24 percent in those who had cycled weekly for 1–59 minutes, 60–149 minutes, 150–299 minutes and ≥300 minutes, respectively.

Analysis using cycling duration as a continuous variable revealed a J–shaped relationship between cycling time and reduction in all-cause mortality — with the maximum benefit seen with around 5 hours of cycling per week. “The benefits persisted until around 9 hours per week,” Ried-Larsen reported.

Similar relationship was seen for CV mortality, with the benefit being the greatest at approximately 4 hours per week, and persisted until 8 hours per week, he noted.

The researchers also looked at the effects of a change in cycling habit on mortality risk.

Interestingly, participants who did not cycle at baseline but picked up cycling in the second survey saw a 35 percent reduction in all-cause mortality risk. Those who continued cycling from baseline until the second survey saw similar benefit, with the a 44 percent reduction in mortality risk.

There was no difference in mortality risk between participants who cycled at baseline but stopped in the second survey and those who did not cycle in both survey periods.

“Cycling was associated with lower all-cause and CV mortality risk among people with diabetes independent of other types of physical activity,” said Ried-Larsen.

According to experts, the findings further support recommendations from the ADA that more physical activity is beneficial for the health of individuals with type 2 diabetes. In fact, regular exercise has been known to reduce death risk across many different health conditions, not just diabetes.

*ADA: American Diabetes Association