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01.01.2014 | Article

Lifestyle factors and mortality risk in individuals with diabetes mellitus: are the associations different from those in individuals without diabetes?

verfasst von: Diewertje Sluik, Heiner Boeing, Kuanrong Li, Rudolf Kaaks, Nina Føns Johnsen, Anne Tjønneland, Larraitz Arriola, Aurelio Barricarte, Giovanna Masala, Sara Grioni, Rosario Tumino, Fulvio Ricceri, Amalia Mattiello, Annemieke M. W. Spijkerman, Daphne L. van der A, Ivonne Sluijs, Paul W. Franks, Peter M. Nilsson, Marju Orho-Melander, Eva Fhärm, Olov Rolandsson, Elio Riboli, Dora Romaguera, Elisabete Weiderpass, Emilio Sánchez-Cantalejo, Ute Nöthlings

Erschienen in: Diabetologia | Ausgabe 1/2014

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Abstract

Aims/hypothesis

Thus far, it is unclear whether lifestyle recommendations for people with diabetes should be different from those for the general public. We investigated whether the associations between lifestyle factors and mortality risk differ between individuals with and without diabetes.

Methods

Within the European Prospective Investigation into Cancer and Nutrition (EPIC), a cohort was formed of 6,384 persons with diabetes and 258,911 EPIC participants without known diabetes. Joint Cox proportional hazard regression models of people with and without diabetes were built for the following lifestyle factors in relation to overall mortality risk: BMI, waist/height ratio, 26 food groups, alcohol consumption, leisure-time physical activity, smoking. Likelihood ratio tests for heterogeneity assessed statistical differences in regression coefficients.

Results

Multivariable adjusted mortality risk among individuals with diabetes compared with those without was increased, with an HR of 1.62 (95% CI 1.51, 1.75). Intake of fruit, legumes, nuts, seeds, pasta, poultry and vegetable oil was related to a lower mortality risk, and intake of butter and margarine was related to an increased mortality risk. These associations were significantly different in magnitude from those in diabetes-free individuals, but directions were similar. No differences between people with and without diabetes were detected for the other lifestyle factors.

Conclusions/interpretation

Diabetes status did not substantially influence the associations between lifestyle and mortality risk. People with diabetes may benefit more from a healthy diet, but the directions of association were similar. Thus, our study suggests that lifestyle advice with respect to mortality for patients with diabetes should not differ from recommendations for the general population.

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Titel: Lifestyle factors and mortality risk in individuals with diabetes mellitus: are the associations different from those in individuals without diabetes?
verfasst von: Diewertje Sluik
Heiner Boeing
Kuanrong Li
Rudolf Kaaks
Nina Føns Johnsen
Anne Tjønneland
Larraitz Arriola
Aurelio Barricarte
Giovanna Masala
Sara Grioni
Rosario Tumino
Fulvio Ricceri
Amalia Mattiello
Annemieke M. W. Spijkerman
Daphne L. van der A
Ivonne Sluijs
Paul W. Franks
Peter M. Nilsson
Marju Orho-Melander
Eva Fhärm
Olov Rolandsson
Elio Riboli
Dora Romaguera
Elisabete Weiderpass
Emilio Sánchez-Cantalejo
Ute Nöthlings
Publikationsdatum: 01.01.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: Diabetologia / Ausgabe 1/2014
Print ISSN: 0012-186X
Elektronische ISSN: 1432-0428
DOI: https://doi.org/10.1007/s00125-013-3074-y

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