Risk factors

Cycling enables people with diabetes to reduce mortality by 24%: study

Cycling appears to have unique health benefits for people with diabetes, over and above those of other types of exercise, a European study has found.

A prospective observational study that enrolled 7459 adults with diabetes found that those who did regular cycling had a 24% lower all-cause mortality risk during 15 years of follow up,  when compared with non-cyclists, independent of other types of physical activity.

And taking up cycling over a five-year period was associated with at least a 35% lower risk of all-cause mortality when compared with consistent non-cyclists, the findings published in JAMA Internal Medicine showed.

Of the study participants  the mean age was 56 years, the mean diabetes duration was 7.7 (years, and 37% were cyclists.

The Hazard Ratio (HR) for all-cause mortality was 0.76 for people who cycled up to 60 minutes per week compared to no-cycling, after adjusting for other physical activity and other co-founders. The mortality risk for lower people who did higher levels of cycling each week,  with a HR of 0.72 for 60-150 minutes/week and HR  0.65 for 150-300 minutes per week.

A similar pattern was seen for cardiovascular mortality, with a HR of 0.72 for cycling up to one hour a week compared to no cycling, and a HR of 0.55 for people who did up to 300 minutes per week. However the dose response curve was not continuous, with lesser benefits associated with cycling more than 300 minutes per week.

In a subgroup of more than 5400 people with diabetes who were asked about changes in cycling habit, the HR for both all-cause and cardiovascular was under  0.65 for all those who either took up or maintained cycling  over the next five to ten years, compared to those who did not cycle.

The study investigators said the association between cycling and all-cause and CVD mortality in people with diabetes was of the same magnitude and direction as previously observed in the healthy population

They said the additional benefit of cycling may stem from the higher intensity of regular exercise it provided  compared to other forms of physical activity, and which must outweigh any increased mortality from accidents and injuries.

“The present investigation extends the level of evidence within this field by documenting that cycling and taking up cycling may offer specific health benefits in people with diabetes over and above other physical activities, including walking,” they concluded.

In an accompanying commentary, the editors of the journal said evidence of the benefits of cycling in diabetes deserved to be shared, not only to improve population health, but also to promote a healthier environment.

“We recognise that cycling requires fitness, a good sense of balance, and the means to purchase a bicycle. We also understand that regular cycling requires living in an area where it is reasonably safe, and we celebrate the installation of more bike lanes, particularly protected lanes, in many cities around the world,” they wrote.

“The analysis …  strengthens the epidemiologic data on cycling and strongly suggests that it may contribute directly to longer and healthier lives. As avid and/or aspiring cyclists ourselves, we are sold on the mental and physical benefits of getting to work and seeing the world on 2 wheels, self-propelled, and think it is well worth a try” they concluded.

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