• M Wei, L W Gibbons, J B Kampert, M Z Nichaman, and S N Blair.
• The Cooper Institute and The Cooper Clinic, Dallas, Texas 75230, USA. mwei@cooperinst.org
• Ann. Intern. Med. 2000 Apr 18; 132 (8): 605611605-11.

BackgroundAlthough physical activity is recommended as a basic treatment for patients with diabetes, its long-term association with mortality in these patients is unknown.ObjectiveTo evaluate the association of low cardiorespiratory fitness and physical inactivity with mortality in men with type 2 diabetes.DesignProspective cohort study.SettingPreventive medicine clinic.Patients1263 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.MeasurementsCardiorespiratory fitness measured by a maximal exercise test, self-reported physical inactivity at baseline, and subsequent death determined by using the National Death Index.ResultsDuring 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% CI, 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 (CI, 1.2-fold to 2.3-fold) higher than that in men who reported being physically active.ConclusionsLow 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.

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