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Protective role of physical activity on type 2 diabetes: Analysis of effect modification by race-ethnicity.

ABSTRACT: BACKGROUND:It is well known physical activity (PA) plays a role in the prevention of type 2 diabetes (T2D). However, the extent to which PA may affect T2D risk among different race-ethnic groups is unknown. Therefore, the aim of the present study was to systematically examine the effect modification of race-ethnicity on PA and T2D. METHODS:The PubMed and Embase databases were systematically searched through June 2016. Study assessment for inclusion was conducted in three phases: title review (n?=?13?022), abstract review (n?=?2200), and full text review (n?=?265). In all, 27 studies met the inclusion criteria and were used in the analysis. Relative risks (RRs) and 95% confidence intervals (CIs) were extracted and analyzed using Comprehensive Meta-Analysis software. All analyses used a random-effects model. RESULTS:A significant protective summary RR, comparing the most active group with the least active PA group, was found for non-Hispanic White (RR 0.71, 95% CI 0.60-0.85), Asians (RR 0.76, 95% CI 0.67-0.85), Hispanics (RR 0.75, 95% CI 0.64-0.89), and American Indians (RR 0.73, 95% CI 0.60-0.88). The summary effect for non-Hispanic Blacks (RR 0.91, 95% CI 0.76-1.08) was not significant. CONCLUSIONS:The results of the present study indicate that PA (comparing most to least active groups) provides significant protection from T2D, with the exception of non-Hispanic Blacks. The results also indicate a need for race-ethnicity-specific reporting of RRs in prospective cohort studies that incorporate multiethnic samples.

SUBMITTER: Boyer WR

PROVIDER: S-EPMC5701882 | biostudies-literature | 2018 Feb

REPOSITORIES: biostudies-literature

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Protective role of physical activity on type 2 diabetes: Analysis of effect modification by race-ethnicity.

Boyer William R WR Churilla James R JR Ehrlich Samantha F SF Crouter Scott E SE Hornbuckle Lyndsey M LM Fitzhugh Eugene C EC

Journal of diabetes 20170704 2

<h4>Background</h4>It is well known physical activity (PA) plays a role in the prevention of type 2 diabetes (T2D). However, the extent to which PA may affect T2D risk among different race-ethnic groups is unknown. Therefore, the aim of the present study was to systematically examine the effect modification of race-ethnicity on PA and T2D.<h4>Methods</h4>The PubMed and Embase databases were systematically searched through June 2016. Study assessment for inclusion was conducted in three phases: t ...[more]

PMID: 28544478

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Project description:ObjectiveTo review the evidence of the association between performance in eight indicators of diabetes care and a patient's race/ethnicity and socioeconomic characteristics.Data sourceStudies of adult patients with type 2 diabetes in MEDLINE published between January 1, 2000, and December 31, 2018.Study designSystematic review and meta-analysis of regression-based studies including race/ethnicity and income or education as explanatory variables. Meta-analysis was used to quantify differences in performance associated with patient race/ethnicity or socioeconomic characteristics. The systematic review was used to identify potential mechanisms of disparities.Data collectionTwo coauthors separately conducted abstract screening, study exclusions, data extraction, and scoring of retained studies. Estimates in retained studies were extracted and, where applicable, were standardized and converted to odds ratios and standard errors.Principal findingsPerformance in intermediate outcomes and process measures frequently exhibited differences by race/ethnicity even after adjustment for socioeconomic, lifestyle, and health factors. Meta-analyses showed black patients had lower odds of HbA1c and blood pressure (BP) control (OR range: 0.67-0.68, P < .05) but higher odds of receiving eye or foot examination (OR range: 1.22-1.47, P < .05) relative to white patients. A high school degree or more was associated with higher odds of HbA1c control and receipt of eye examinations compared to patients without a degree. Meta-analyses of income included a handful of studies and were inconsistently associated with diabetes care performance. Differences in diabetes performance appear to be related to access-related factors such as uninsurance or lacking a usual source of care; food insecurity and trade-offs at very low incomes; and lower adherence among younger and healthier diabetes patients.ConclusionsPatient race/ethnicity and education were associated with differences in diabetes quality measures. Depending on the approach used to rate providers, not adjusting for these patient characteristics may penalize or reward providers based on the populations they serve.

Project description:BackgroundIndividuals with diabetes exhibit a higher risk of cardiovascular disease and mortality compared to healthy individuals. Following a transient ischemic attack (TIA) the risk of stroke and death increase further. Physical activity engagement after a TIA is an effective way of secondary prevention. However, there's a lack of research on how individuals with diabetes modify physical activity levels and how these adjustments impact survival post-TIA. This study aimed to determine the extent to which individuals with diabetes alter their physical activity levels following a TIA and to assess the impact of these changes on mortality.MethodsThis was a nationwide longitudinal study, employing data from national registers in Sweden spanning from 01/01/2003 to 31/12/2019. Data were collected 2 years retro- and prospectively of TIA occurrence, in individuals with diabetes. Individuals were grouped based on decreasing, remaining, or increasing physical activity levels after the TIA. Cox proportional hazards models were fitted to evaluate the adjusted relationship between change in physical activity and all-cause, cardiovascular, and non-cardiovascular mortality.ResultsThe final study sample consisted of 4.219 individuals (mean age 72.9 years, 59.4% males). Among them, 35.8% decreased, 37.5% kept steady, and 26.8% increased their physical activity after the TIA. A subsequent stroke occurred in 6.7%, 6.4%, and 6.1% of individuals, while death occurred in 6.3%, 7.3%, and 3.7% of individuals, respectively. In adjusted analyses, participants who increased their physical activity had a 45% lower risk for all-cause mortality and a 68% lower risk for cardiovascular mortality, compared to those who decreased their physical activity.ConclusionsPositive change in physical activity following a ΤΙΑ was associated with a reduced risk of mortality. Increased engagement in physical activity should be promoted after TIA, thereby actively supporting individuals with diabetes in achieving improved health outcomes.

Dataset Information

Protective role of physical activity on type 2 diabetes: Analysis of effect modification by race-ethnicity.

Publications

Protective role of physical activity on type 2 diabetes: Analysis of effect modification by race-ethnicity.

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