The association of physical activity and sedentary behaviour with the development and progression of microvascular complications in type 1 and type 2 diabetes: A systematic review of cohort studies
Authors' conclusion
Higher PA was associated with some favourable longitudinal microvascular outcomes, mainly in T2D, but residual confounding, self-reported exposures and heterogeneous outcomes limit interpretation. Evidence on SB was restricted to one small cohort and cannot establish its association with incident microvascular complications.
Study context
- Population
- Adults with type 1 (T1D) or type 2 diabetes (T2D); prospective or retrospective cohort studies comparing physical activity (PA) or sedentary behaviour (SB) levels in relation to retinopathy, nephropathy, neuropathy or severe neuropathy-related foot outcomesstudies included (nine prospective and three retrospective), reported sample sizes summed to 2.55 million, participants not necessarily unique · prospective studies nine · retrospective studies three
- Participants
- Twelve studies adults
- Comparison
- PA or SB levels in relation to microvascular complications
- Outcome
- Aggregate sample size
Methodological detailsnarrative synthesis, risk of bias assessed with ROBINS-E
- Narrative synthesis
- Risk of bias assessed with ROBINS-E
Pooled result
As reported in the abstract
Reported sample sizes summed to
2.55 million
One South Korean registry contributed
2,495,031 participants, ≈98 % of this total
Further pooled results
First diabetic foot ulcer (SB evidence, one cohort of 175 participants with established diabetic peripheral neuropathy)
| OR (95 % CI) | ||
|---|---|---|
| Greater sedentary timeGreater sedentary time associated with higher odds | 2.95 (1.45–6.44) | |
| 0.10.31310Odds ratio (log scale) |
- First diabetic foot ulcer (SB evidence, one cohort of 175 participants with established diabetic peripheral neuropathy): Evidence on SB was restricted to one cohort of 175 participants
Renal, neuropathic and retinopathy outcomes with higher PA
- Higher PA was associated with lower risk of several renal and neuropathic outcomes, predominantly in T2D
- Retinopathy findings varied
Original publication
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