Frequent physical activity is associated with reduced risk of severe diabetic retinopathy in type 1 diabetes

Abstract

Aims The aim of this study was to investigate whether leisure-time physical activity (LTPA) is associated with the development of severe diabetic retinopathy in individuals with type 1 diabetes. Methods Prospective observational analysis as part of the Finnish diabetic nephropathy (FinnDiane) Study with a mean follow-up time of 10.7 years was performed. A total of 1612 individuals with type 1 diabetes were recruited, and LTPA was assessed at baseline using a validated self-report questionnaire. Severe diabetic retinopathy was defined as the initiation of laser treatment due to severe nonproliferative, proliferative retinopathy or diabetic maculopathy (identified from the Care Register for Health Care). Results A total of 261 patients received laser treatment during the follow-up. Higher frequency of LTPA was associated with a lower incidence of severe diabetic retinopathy (p = 0.024), a finding that remained significant after adjustment for gender, duration, age at onset of diabetes, kidney function, BMI, triglycerides and systolic blood pressure. However, when HbA 1c and smoking were added to the Cox regression model the association was no more significant. Conclusions Frequent LTPA is associated with a lower incidence of severe diabetic retinopathy during the follow-up. The total amount or the other components of LTPA (intensity or duration of a single session) were not associated with severe diabetic retinopathy.

Iranian National Clinical Practice Guideline for Exercise in Patients with Diabetes

“…In a recent meta-analysis by Ren et al, authors revealed that physical activity has a slight protective association with retinopathy in patients with diabetes, and the impact was more pronounced on vision-threatening retinopathies (109). The amount of exercise or its components (time or intensity of each session) were not linked with severe retinopathy (110).…”

“…However, due to the risk of vitreous hemorrhage and retinal detachment in patients with unstable diabetic retinopathy, special exercise cautions are needed (32). In conclusion, the proper exercise program should be tailored for patients with diabetic retinopathy, especially in the mild and stable forms (26,32,73,109,110).…”

Can Resistance Exercise Be a Tool for Healthy Aging in Post-Menopausal Women with Type 1 Diabetes?

“…In addition, exercise also lowers the risk of a variety of chronic conditions, such as type 2 diabetes [93], CVD [95], hypertension [96], and dementia [97], while slowing age-related decline in physical function [98]. In those with T1D in particular, exercise and physical activity are associated with not only greater longevity [99,100], but also a decrease in the frequency and severity of diabetes-related complications [101][102][103].…”

Advantages of physical activity of varying intensity for patients with type 1 diabetes and its influence on glucose metabolism

“…Пациентам с пролиферативной или тяжелой непролиферативной диабетической ретинопатией противопоказаны силовые тренировки и интенсивные упражнения или соревнования на выносливость из-за риска спровоцировать кровоизлияние в стекловидное тело или отслойку сетчатки [38]; гемофтальм, отслойка сетчатки, первые полгода после лазеркоагуляции сетчатки являются ограничениями для любых видов физических упражнений [39].…”