Physical activity, sedentary behavior and all-cause mortality among blacks and whites with diabetes

Abstract

Purpose The study objective was to examine the role of physical activity (PA) and sedentary time (ST) on mortality risk among a population of low-income adults with diabetes. Methods Black (n = 11,137) and white (n = 4508) men and women with diabetes from the Southern Community Cohort Study self-reported total PA levels and total ST. Participants were categorized into quartiles of total PA and total ST. Hazard ratios (HRs) and 95% confidence intervals (CIs) for subsequent mortality risk were estimated from Cox proportional hazards analysis with adjustment for potential confounders. Results During follow-up, 2370 participants died. The multivariable risk of mortality was lower among participants in the highest quartile of PA compared with those in the lowest quartile (HR, 0.64; 95% CI: 0.57–0.73). Mortality risk was significantly increased among participants in the highest compared with the lowest quartile of ST after adjusting for PA (HR, 1.21; 95% CI: 1.08–1.37). Across sex and race groups, similar trends of decreasing mortality with rising PA and increasing mortality with rising ST were observed. Conclusions Although causality cannot be established from these observational data, the current findings suggest that increasing PA and decreasing ST may help extend survival among individuals with diabetes irrespective of race and sex.

Self-Care Disparities Among Adults with Type 2 Diabetes in the USA

“…Ten studies[51–60] assessed disparities in exercise or physical activity, with seven[52–56; 58; 59] assessing adjusted disparities. Studies reporting NHBs performed less physical activity than NHWs showed small disparities that became nonsignificant after adjustment for covariates.…”

“…Studies reporting NHBs performed less physical activity than NHWs showed small disparities that became nonsignificant after adjustment for covariates. [55; 58; 60] No studies found a significant disparity between Hispanics and NHBs. Evidence of a disparity in physical activity between Hispanics and NHWs was mixed.…”

“…[59] In other words, NHB men reported exercising regularly, but were participating in less rigorous exercise than other groups. Other studies with larger, representative samples either reported no disparities[53; 55] or unadjusted evidence of reverse disparities (with either NHBs[59; 60] or Hispanics[59] reporting more physical activity than NHWs). Overall, evidence on physical activity indicates disparities are small and are not significant after adjustment for measured confounding variables.…”

“…Four studies[55–57; 60] assessed smoking status as part of diabetes self-management. Glenn et al[60] found NHBs are more likely to report never smoking than NHWs, but found similar rates of current smoking (each ~29%) in the Southern Community Cohort Study.…”

“…Glenn et al[60] found NHBs are more likely to report never smoking than NHWs, but found similar rates of current smoking (each ~29%) in the Southern Community Cohort Study. Johnson et al[55] found NHWs smoked less than NHBs but this disparity did not persist in adjusted analyses.…”