Occupational, commuting, and leisure-time physical activity in relation to total and cardiovascular mortality among Finnish subjects with type 2 diabetes

Circulation. 2004 Aug 10;110(6):666-73. doi: 10.1161/01.CIR.0000138102.23783.94. Epub 2004 Jul 26.


Background: Some previous studies have assessed the association between leisure-time physical activity and mortality among patients with diabetes, but the potential effect of occupational and commuting physical activity remains uncertain.

Methods and results: We prospectively followed up 3316 Finnish participants 25 to 74 years of age with type 2 diabetes. The association of different types of physical activity with mortality was examined with Cox proportional-hazard models. During a mean follow-up of 18.4 years, 1410 deaths were recorded, 903 of which were due to cardiovascular disease (CVD). The multivariate-adjusted (age, sex, study year, body mass index, systolic blood pressure, cholesterol, smoking, and the 2 other types of physical activity) hazard ratios associated with light, moderate, and active work were 1.00, 0.86, and 0.60 (P(trend)<0.001) for total mortality and 1.00, 0.91, and 0.60 (P(trend)<0.001) for CVD mortality, respectively. The multivariate-adjusted hazard ratios associated with low, moderate, and high leisure-time physical activity were 1.00, 0.82, and 0.71 (P(trend)<0.001) for total mortality and 1.00, 0.83, and 0.67 (P(trend)=0.005) for CVD mortality, respectively. Active commuting had significant inverse associations with total and CVD mortality, but these relations were no longer significant after additional adjustment for occupational and leisure-time physical activity.

Conclusions: Moderate or high levels of physical activity reduce total and CVD mortality among patients with type 2 diabetes. Not only leisure-time physical activity but also occupational and commuting physical activities are important components of a healthy lifestyle among patients with diabetes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cardiovascular Diseases / mortality*
  • Cardiovascular Diseases / prevention & control
  • Comorbidity
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Finland / epidemiology
  • Follow-Up Studies
  • Health Surveys
  • Humans
  • Leisure Activities*
  • Life Style
  • Motor Activity*
  • Occupations / statistics & numerical data*
  • Proportional Hazards Models
  • Prospective Studies
  • Sampling Studies
  • Surveys and Questionnaires
  • Transportation / statistics & numerical data*