Exercise capacity and body mass as predictors of mortality among male veterans with type 2 diabetes

Diabetes Care. 2007 Jun;30(6):1539-43. doi: 10.2337/dc06-2397. Epub 2007 Mar 10.


Objective: To demonstrate the relation of exercise capacity and BMI to mortality in a population of male veterans with type 2 diabetes.

Research design and methods: After excluding two underweight patients (BMI <18.5 kg/m2), the study population comprised 831 consecutive patients with type 2 diabetes (mean age 61 +/- 9 years) referred for exercise testing for clinical reasons between 1995 and 2006. Exercise capacity was determined from a maximal exercise test and measured in metabolic equivalents (METs). Patients were classified both according to BMI category (18.5-24.9, 25.0-29.9, and > or =30 kg/m2) and by exercise capacity (<5.0 or > or =5.0 maximal METs). The association among exercise capacity, BMI, other clinical variables, and all-cause mortality was assessed by Cox proportional hazards. Study participants were followed for mortality up to 30 June 2006.

Results: During a mean follow-up of 4.8 +/- 3.0 years, 112 patients died, for an average annual mortality rate of 2.2%. Each 1-MET increase in exercise capacity conferred a 10% survival benefit (hazard ratio 0.90 [95% CI 0.82-0.98]; P = 0.01), but BMI was not significantly associated with mortality. After adjustment for age, ethnicity, examination year, BMI, presence of cardiovascular disease (CVD), and CVD risk factors, diabetic patients achieving <5 maximal METs were 70% more likely to die (1.70 [1.13-2.54]) than those achieving > or =5 maximal METs.

Conclusions: There was a strong inverse association between exercise capacity and mortality in this cohort of men with documented diabetes, and this relationship was independent of BMI.

MeSH terms

  • Aged
  • Blood Pressure
  • Body Weight*
  • Cohort Studies
  • Databases, Factual
  • Diabetes Mellitus, Type 2 / mortality*
  • Diabetes Mellitus, Type 2 / physiopathology
  • Exercise / physiology*
  • Exercise Test
  • Follow-Up Studies
  • Heart Rate
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Smoking / epidemiology
  • Survival Analysis
  • Time Factors
  • United States
  • Veterans*