Impact of Lifestyle-Related Factors on All-Cause and Cause-Specific Mortality in Patients With Type 2 Diabetes

Author:

Lin Cheng-Chieh1234,Li Chia-Ing145,Liu Chiu-Shong12,Lin Wen-Yuan124,Fuh Martin Mao-Tsu6,Yang Sing-Yu7,Lee Cheng-Chun18,Li Tsai-Chung37

Affiliation:

1. School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; the

2. Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan; the

3. Department of Healthcare Administration, College of Health Science, Asia University, Taichung, Taiwan; the

4. Department of Medical Research, China Medical University Hospital, Taichung, Taiwan; the

5. Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan; the

6. Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung, Taiwan; the

7. Graduate Institute of Biostatistics, China Medical University, Taichung, Taiwan; and the

8. Department of Neurology, China Medical University Hospital, Taichung, Taiwan.

Abstract

OBJECTIVE To examine whether combined lifestyle behaviors have an impact on all-cause and cause-specific mortality in patients aged 30–94 years with type 2 diabetes (T2DM). RESEARCH DESIGN AND METHODS Participants included 5,686 patients >30 years old with T2DM who were enrolled in a Diabetes Care Management Program at a medical center in central Taiwan before 2007. Lifestyle behaviors consisted of smoking, alcohol drinking, physical inactivity, and carbohydrate intake. The main outcomes were all-cause and cause-specific mortality. Cox proportional hazards models were used to examine the association between combined lifestyle behaviors and mortality. RESULTS The mortality rate among men was 24.10 per 1,000 person-years, and that among women was 17.25 per 1,000 person-years. After adjusting for the traditional risk factors, we found that combined lifestyle behavior was independently associated with all-cause mortality and mortality due to diabetes, cardiovascular disease, and cancer. Patients with three or more points were at a 3.50-fold greater risk of all-cause mortality (95% CI 2.06–5.96) and a 4.94-fold (1.62–15.06), 4.24-fold (1.20–14.95), and 1.31-fold (0.39–4.41) greater risk of diabetes-specific, CVD-specific, and cancer-specific mortality, respectively, compared with patients with zero points. Among these associations, the combined lifestyle behavior was not significantly associated with cancer mortality. CONCLUSIONS Combined lifestyle behavior is a strong predictor of all-cause and cause-specific mortality in patients with T2DM.

Publisher

American Diabetes Association

Subject

Advanced and Specialized Nursing,Endocrinology, Diabetes and Metabolism,Internal Medicine

Reference24 articles.

1. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Disease. National diabetes statistics: 2007 fact sheet [article online], 2008. Available from http://diabetes.niddk.nih.gov/dm/pubs/statistics. Accessed 2 February 2011

2. International Diabetes Federation. The diabetes atlas [article online], 2006. 3rd ed. Available from http://www.eatlas.idf.org/media/. Accessed 2 February 2011

3. Department of Health and Executive Yuan. The prevalence of type 2 diabetes mellitus [article online], 2009. Taipei, Taiwan, Department of Health. Available from http://www.doh.gov.tw/EN2006/index_EN.aspx. Accessed 2 February 2011

4. Lifestyle risk factors and new-onset diabetes mellitus in older adults: the cardiovascular health study;Mozaffarian;Arch Intern Med,2009

5. Ten-year mortality and cardiovascular morbidity in the Finnish Diabetes Prevention Study—secondary analysis of the randomized trial;Uusitupa;PLoS ONE,2009

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