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Erschienen in: Acta Diabetologica 4/2017

08.12.2016 | Original Article

Costs of diabetes medication among male former elite athletes in later life

verfasst von: M. K. Laine, R. Kujala, J. G. Eriksson, H. Kautiainen, S. Sarna, U. M. Kujala

Erschienen in: Acta Diabetologica | Ausgabe 4/2017

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Abstract

Aims

Regular physical activity plays a major role, in both prevention and treatment of type 2 diabetes. Less is known whether vigorous physical activity during young adulthood is associated with costs of diabetes medication in later life. The aim of this study is to evaluate this question.

Methods

The study population consisted of 1314 former elite-class athletes and 860 matched controls. The former athletes were divided into three groups based on their active career sport: endurance, mixed and power sports. Information on purchases of diabetes medication between 1995 and 2009 was obtained from the drug purchase register of the Finnish Social Insurance Institution.

Results

The total cost of diabetes medication per person year was significantly lower among the former endurance (mean 81 € [95% CI 33–151 €]) and mixed group athletes (mean 272 € [95% CI 181–388 €]) compared with the controls (mean 376 € [95% CI 284–485 €]), (p < 0.001 and p = 0.045, respectively). Of the former endurance athletes, 0.4% used insulin, while 5.2% of the controls used insulin (p = 0.018).

Conclusions

A career as former endurance, sprint, jumper or team game athlete seems to reduce the costs of diabetes medication in later life.
Literatur
2.
Zurück zum Zitat Helmrich SP, Ragland DR, Leung RW, Paffenbarger RS Jr (1991) Physical activity and reduced occurrence of non-insulin-dependent diabetes mellitus. N Engl J Med 325:147–152CrossRefPubMed Helmrich SP, Ragland DR, Leung RW, Paffenbarger RS Jr (1991) Physical activity and reduced occurrence of non-insulin-dependent diabetes mellitus. N Engl J Med 325:147–152CrossRefPubMed
3.
Zurück zum Zitat Lynch J, Helmrich SP, Lakka TA et al (1996) Moderately intense physical activities and high levels of cardiorespiratory fitness reduce the risk of non-insulin-dependent diabetes mellitus in middle-aged men. Arch Intern Med 156:1307–1314CrossRefPubMed Lynch J, Helmrich SP, Lakka TA et al (1996) Moderately intense physical activities and high levels of cardiorespiratory fitness reduce the risk of non-insulin-dependent diabetes mellitus in middle-aged men. Arch Intern Med 156:1307–1314CrossRefPubMed
4.
Zurück zum Zitat Pan XR, Li GW, Hu YH et al (1997) Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance. The Da Qing IGT and diabetes study. Diabetes Care 20:537–544CrossRefPubMed Pan XR, Li GW, Hu YH et al (1997) Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance. The Da Qing IGT and diabetes study. Diabetes Care 20:537–544CrossRefPubMed
5.
Zurück zum Zitat Tuomilehto J, Lindstrom J, Eriksson JG et al (2001) Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 344:1343–1350CrossRefPubMed Tuomilehto J, Lindstrom J, Eriksson JG et al (2001) Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 344:1343–1350CrossRefPubMed
6.
Zurück zum Zitat Knowler WC, Barrett-Connor E, Fowler SE et al (2002) Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 346:393–403CrossRefPubMed Knowler WC, Barrett-Connor E, Fowler SE et al (2002) Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 346:393–403CrossRefPubMed
7.
Zurück zum Zitat Espeland MA, Glick HA, Bertoni A, Look AHEAD Research Group et al (2014) Impact of an intensive lifestyle intervention on use and cost of medical services among overweight and obese adults with type 2 diabetes: the action for health in diabetes. Diabetes Care 37:2548–2556CrossRefPubMedPubMedCentral Espeland MA, Glick HA, Bertoni A, Look AHEAD Research Group et al (2014) Impact of an intensive lifestyle intervention on use and cost of medical services among overweight and obese adults with type 2 diabetes: the action for health in diabetes. Diabetes Care 37:2548–2556CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Paffenbarger RS Jr, Jung DL, Leung RW, Hyde RT (1991) Physical activity and hypertension: an epidemiological view. Ann Med 23:319–327CrossRefPubMed Paffenbarger RS Jr, Jung DL, Leung RW, Hyde RT (1991) Physical activity and hypertension: an epidemiological view. Ann Med 23:319–327CrossRefPubMed
9.
Zurück zum Zitat Laine MK, Eriksson JG, Kujala UM et al (2014) A former career as a male elite athlete-does it protect against type 2 diabetes in later life? Diabetologia 57:270–274CrossRefPubMed Laine MK, Eriksson JG, Kujala UM et al (2014) A former career as a male elite athlete-does it protect against type 2 diabetes in later life? Diabetologia 57:270–274CrossRefPubMed
10.
Zurück zum Zitat Umpierre D, Ribeiro PAB, Kramer CK et al (2011) Physical activity advice only or structured exercise training and association with HbA1c levels in type 2 diabetes. JAMA 305:1790–1799CrossRefPubMed Umpierre D, Ribeiro PAB, Kramer CK et al (2011) Physical activity advice only or structured exercise training and association with HbA1c levels in type 2 diabetes. JAMA 305:1790–1799CrossRefPubMed
11.
Zurück zum Zitat McGinley SK, Armstrong MJ, Boule NG, Sigal RJ (2015) Effects of exercise training using resistance bands on glycaemic control and strenght in type 2 diabetes mellitus: a meta-analysis of randomised controlled trials. Acta Diabetol 52:221–230CrossRefPubMed McGinley SK, Armstrong MJ, Boule NG, Sigal RJ (2015) Effects of exercise training using resistance bands on glycaemic control and strenght in type 2 diabetes mellitus: a meta-analysis of randomised controlled trials. Acta Diabetol 52:221–230CrossRefPubMed
12.
Zurück zum Zitat Liubaoerjijin Y, Terada T, Fletcher K, Boule NG (2016) Effect of aerobic intensity on glycemic control in type 2 diabetes: a meta-analysis of head-to-head randomized trials. Acta Diabetol 53:769–781CrossRefPubMed Liubaoerjijin Y, Terada T, Fletcher K, Boule NG (2016) Effect of aerobic intensity on glycemic control in type 2 diabetes: a meta-analysis of head-to-head randomized trials. Acta Diabetol 53:769–781CrossRefPubMed
14.
Zurück zum Zitat Boule NG, Liubaoerjijin Y, Terada T (2016) Reply to Elsamma Chacko: “ timing, intensity and frequency of exercise for glucose control”. Acta Diabetol. doi:10.1007/s00592-016-0887-4 Boule NG, Liubaoerjijin Y, Terada T (2016) Reply to Elsamma Chacko: “ timing, intensity and frequency of exercise for glucose control”. Acta Diabetol. doi:10.​1007/​s00592-016-0887-4
15.
Zurück zum Zitat Balducci S, Vulpiani MC, Pugliese L et al (2014) Effect of supervised exercise training on musculoskeletal symptoms and function in patients with type 2 diabetes: the Italian Diabetes Exercise Study (IDES). Acta Diabetol 51:647–654CrossRefPubMed Balducci S, Vulpiani MC, Pugliese L et al (2014) Effect of supervised exercise training on musculoskeletal symptoms and function in patients with type 2 diabetes: the Italian Diabetes Exercise Study (IDES). Acta Diabetol 51:647–654CrossRefPubMed
16.
Zurück zum Zitat Sarna S, Sahi T, Koskenvuo M, Kaprio J (1993) Increased life expectancy of world class male athletes. Med Sci Sports Exerc 25:237–244CrossRefPubMed Sarna S, Sahi T, Koskenvuo M, Kaprio J (1993) Increased life expectancy of world class male athletes. Med Sci Sports Exerc 25:237–244CrossRefPubMed
17.
Zurück zum Zitat Åstrand P, Rodahl K (1986) Physiological bases of exercise. In: Textbook of work physiology. McGraw Hill, New York, pp 412–415 Åstrand P, Rodahl K (1986) Physiological bases of exercise. In: Textbook of work physiology. McGraw Hill, New York, pp 412–415
21.
Zurück zum Zitat Kujala UM, Sarna S, Kaprio J (2003) Use of medications and dietary supplements in later years among male former top-level athletes. Arch Intern Med 163:1064–1068CrossRefPubMed Kujala UM, Sarna S, Kaprio J (2003) Use of medications and dietary supplements in later years among male former top-level athletes. Arch Intern Med 163:1064–1068CrossRefPubMed
22.
Zurück zum Zitat Sarna S, Kaprio J, Kujala UM, Koskenvuo M (1997) Health status of former elite athletes. The Finnish experience. Aging (Milano) 9:35–41 Sarna S, Kaprio J, Kujala UM, Koskenvuo M (1997) Health status of former elite athletes. The Finnish experience. Aging (Milano) 9:35–41
24.
Zurück zum Zitat Palmer AJ, Roze S, Valentine WJ, Spinas GA, Shaw JE, Zimmet PZ (2004) Intensive lifestyle changes or metformin in patients with impaired glucose tolerance: modeling the long-term health economic implications of the diabetes prevention program in Australia, France, Germany, Switzerland, and the United Kingdom. Clin Ther 26:304–321CrossRefPubMed Palmer AJ, Roze S, Valentine WJ, Spinas GA, Shaw JE, Zimmet PZ (2004) Intensive lifestyle changes or metformin in patients with impaired glucose tolerance: modeling the long-term health economic implications of the diabetes prevention program in Australia, France, Germany, Switzerland, and the United Kingdom. Clin Ther 26:304–321CrossRefPubMed
25.
Zurück zum Zitat Diabetes Prevention Program Research Group (2012) The 10-year cost-effectiveness of lifestyle intervention or metformin for diabetes prevention: an intent-to-treat analysis of the DPP/DPPOS. Diabetes Care 35:723–730CrossRef Diabetes Prevention Program Research Group (2012) The 10-year cost-effectiveness of lifestyle intervention or metformin for diabetes prevention: an intent-to-treat analysis of the DPP/DPPOS. Diabetes Care 35:723–730CrossRef
26.
Zurück zum Zitat Liu X, Li C, Gong H et al (2013) An economic evaluation for prevention of diabetes mellitus in a developing country: a modelling study. BMC Public Health. doi:10.1186/1471-2458-13-729 Liu X, Li C, Gong H et al (2013) An economic evaluation for prevention of diabetes mellitus in a developing country: a modelling study. BMC Public Health. doi:10.​1186/​1471-2458-13-729
27.
Zurück zum Zitat Saha S, Carlsson KS, Gerdtham UG et al (2013) Are lifestyle interventions in primary care cost-effective?—An analysis based on a Markov model, differences-in-differences approach and the Swedish Bjorknas study. PLoS ONE. doi:10.1371/journal.pone.0080672 Saha S, Carlsson KS, Gerdtham UG et al (2013) Are lifestyle interventions in primary care cost-effective?—An analysis based on a Markov model, differences-in-differences approach and the Swedish Bjorknas study. PLoS ONE. doi:10.​1371/​journal.​pone.​0080672
28.
Zurück zum Zitat Bertram MY, Lim SS, Barendregt JJ, Vos T (2010) Assessing the cost-effectiveness of drug and lifestyle intervention following opportunistic screening for pre-diabetes in primary care. Diabetologia 53:875–881CrossRefPubMed Bertram MY, Lim SS, Barendregt JJ, Vos T (2010) Assessing the cost-effectiveness of drug and lifestyle intervention following opportunistic screening for pre-diabetes in primary care. Diabetologia 53:875–881CrossRefPubMed
29.
Zurück zum Zitat Balducci S, Sacchetti M, Haxhi J et al (2014) Physical exercise as therapy for type 2 diabetes mellitus. Diabetes Metab Res Rev. doi:10.1002/dmrr.2514 Balducci S, Sacchetti M, Haxhi J et al (2014) Physical exercise as therapy for type 2 diabetes mellitus. Diabetes Metab Res Rev. doi:10.​1002/​dmrr.​2514
30.
Zurück zum Zitat Kujala UM (2011) Physical activity, genes, and lifetime predisposition to chronic disease. European review of aging and physical activity: 31–36 Kujala UM (2011) Physical activity, genes, and lifetime predisposition to chronic disease. European review of aging and physical activity: 31–36
31.
Zurück zum Zitat Colberg SR, Sigal RJ, Fernhall B et al (2010) Exercise and type 2 diabetes: the American College of Sports Medicine and the American Diabetes Association: joint position statement executive summary. Diabetes Care 33:2692–2696CrossRefPubMedPubMedCentral Colberg SR, Sigal RJ, Fernhall B et al (2010) Exercise and type 2 diabetes: the American College of Sports Medicine and the American Diabetes Association: joint position statement executive summary. Diabetes Care 33:2692–2696CrossRefPubMedPubMedCentral
32.
Zurück zum Zitat Yusuf S, Reddy S, Ounpuu S, Anand S (2001) Global burden of cardiovascular diseases: part I: general considerations, the epidemiologic transition, risk factors, and impact of urbanization. Circulation 104:2746–2753CrossRefPubMed Yusuf S, Reddy S, Ounpuu S, Anand S (2001) Global burden of cardiovascular diseases: part I: general considerations, the epidemiologic transition, risk factors, and impact of urbanization. Circulation 104:2746–2753CrossRefPubMed
34.
Zurück zum Zitat Richter EA, Hargreaves M (2013) Exercise, GLUT4, and skeletal muscle glucose uptake. Physiol Rev 93:993–1017CrossRefPubMed Richter EA, Hargreaves M (2013) Exercise, GLUT4, and skeletal muscle glucose uptake. Physiol Rev 93:993–1017CrossRefPubMed
35.
Zurück zum Zitat Christ-Roberts CY, Pratipanawatr T, Pratipanawatr W et al (2004) Exercise training increases glycogen synthase activity and GLUT4 expression but not insulin signaling in overweight nondiabetic and type 2 diabetic subjects. Metabolism 53:1233–1242CrossRefPubMed Christ-Roberts CY, Pratipanawatr T, Pratipanawatr W et al (2004) Exercise training increases glycogen synthase activity and GLUT4 expression but not insulin signaling in overweight nondiabetic and type 2 diabetic subjects. Metabolism 53:1233–1242CrossRefPubMed
36.
Zurück zum Zitat Costill DL, Fink WJ, Pollock ML (1976) Muscle fiber composition and enzyme activities of elite distance runners. Med Sci Sports 8:96–100PubMed Costill DL, Fink WJ, Pollock ML (1976) Muscle fiber composition and enzyme activities of elite distance runners. Med Sci Sports 8:96–100PubMed
37.
Zurück zum Zitat Lundsgaard AM, Kiens B (2014) Gender differences in skeletal muscle substrate metabolism—molecular mechanisms and insulin sensitivity. Front Endocrinol. doi:10.3389/fendo.2014.00195 Lundsgaard AM, Kiens B (2014) Gender differences in skeletal muscle substrate metabolism—molecular mechanisms and insulin sensitivity. Front Endocrinol. doi:10.​3389/​fendo.​2014.​00195
38.
Zurück zum Zitat Phielix E, Meex R, Ouwens DM et al (2012) High oxidative capacity due to chronic exercise training attenuates lipid-induced insulin resistance. Diabetes 61:2472–2478CrossRefPubMedPubMedCentral Phielix E, Meex R, Ouwens DM et al (2012) High oxidative capacity due to chronic exercise training attenuates lipid-induced insulin resistance. Diabetes 61:2472–2478CrossRefPubMedPubMedCentral
39.
Zurück zum Zitat Aadahl M, Kjaer M, Jorgensen T (2007) Associations between overall physical activity level and cardiovascular risk factors in an adult population. Eur J Epidemiol 22:369–378CrossRefPubMed Aadahl M, Kjaer M, Jorgensen T (2007) Associations between overall physical activity level and cardiovascular risk factors in an adult population. Eur J Epidemiol 22:369–378CrossRefPubMed
40.
Zurück zum Zitat Philipsen A, Hansen AL, Jorgensen ME et al (2015) Associations of objectively measured physical activity and abdominal fat distribution. Med Sci Sports Exerc 47:983–989CrossRefPubMed Philipsen A, Hansen AL, Jorgensen ME et al (2015) Associations of objectively measured physical activity and abdominal fat distribution. Med Sci Sports Exerc 47:983–989CrossRefPubMed
41.
Zurück zum Zitat Shojaee-Moradie F, Baynes KC, Pentecost C et al (2007) Exercise training reduces fatty acid availability and improves the insulin sensitivity of glucose metabolism. Diabetologia 50:404–413CrossRefPubMed Shojaee-Moradie F, Baynes KC, Pentecost C et al (2007) Exercise training reduces fatty acid availability and improves the insulin sensitivity of glucose metabolism. Diabetologia 50:404–413CrossRefPubMed
42.
Zurück zum Zitat Johnson NA, Sachinwalla T, Walton DW et al (2009) Aerobic exercise training reduces hepatic and visceral lipids in obese individuals without weight loss. Hepatology 50:1105–1112CrossRefPubMed Johnson NA, Sachinwalla T, Walton DW et al (2009) Aerobic exercise training reduces hepatic and visceral lipids in obese individuals without weight loss. Hepatology 50:1105–1112CrossRefPubMed
43.
Zurück zum Zitat van der Heijden GJ, Wang ZJ, Chu ZD et al (2010) A 12-week aerobic exercise program reduces hepatic fat accumulation and insulin resistance in obese, Hispanic adolescents. Obesity 18:384–390CrossRefPubMed van der Heijden GJ, Wang ZJ, Chu ZD et al (2010) A 12-week aerobic exercise program reduces hepatic fat accumulation and insulin resistance in obese, Hispanic adolescents. Obesity 18:384–390CrossRefPubMed
44.
Zurück zum Zitat Kujala UM, Jokelainen J, Oksa H et al (2011) Increase in physical activity and cardiometabolic risk profile change during lifestyle intervention in primary healthcare: 1-year follow-up study among individuals at high risk for type 2 diabetes. BMJ Open. doi:10.1136/bmjopen-2011-000292 PubMedPubMedCentral Kujala UM, Jokelainen J, Oksa H et al (2011) Increase in physical activity and cardiometabolic risk profile change during lifestyle intervention in primary healthcare: 1-year follow-up study among individuals at high risk for type 2 diabetes. BMJ Open. doi:10.​1136/​bmjopen-2011-000292 PubMedPubMedCentral
Metadaten
Titel
Costs of diabetes medication among male former elite athletes in later life
verfasst von
M. K. Laine
R. Kujala
J. G. Eriksson
H. Kautiainen
S. Sarna
U. M. Kujala
Publikationsdatum
08.12.2016
Verlag
Springer Milan
Erschienen in
Acta Diabetologica / Ausgabe 4/2017
Print ISSN: 0940-5429
Elektronische ISSN: 1432-5233
DOI
https://doi.org/10.1007/s00592-016-0947-9

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