Low cardiorespiratory fitness and physical inactivity as predictors of mortality in men with type 2 diabetes

Background: Although physical activity is recommended as a basic treatment for patients with diabetes, its longterm association with mortality in these patients is unknown. Objective: To evaluate the association of low cardiorespiratory fitness and physical inactivity with mortality in men with type 2 diabetes. Design: Prospective cohort study. Setting: Preventive medicine clinic. Patients: 1263 men (50 +/- 10 years of age) with type 2 diabetes who received a thorough medical examination between 1970 and 1993 and were followed for mortality up to 31 December 1994. Measurements: Cardiorespiratory fitness measured by a maximal exercise test, self-reported physical inactivity at baseline, and subsequent death determined by using the National Death Index. Results: During an average follow-up of 12 years, 180 patients died. After adjustment for age, baseline cardiovascular disease, fasting plasma glucose level, high cholesterol level, overweight, current smoking, high blood pressure, and parental history of cardiovascular disease, men in the low-fitness group had an adjusted risk for all-cause mortality of 2.1 (95% Cl, 1.5 to 2.9) compared with fit men. Men who reported being physically inactive had an adjusted risk for mortality that was 1.7-fold (Cl, 1.2-fold to 2.3-fold) higher than that in men who reported being physically active. Conclusions: Low cardiorespiratory fitness and physical inactivity are independent predictors of all-cause mortality in men with type 2 diabetes. Physicians should encourage patients with type 2 diabetes to participate in regular physical activity and improve cardiorespiratory fitness.