Protective effect of regular physical activity against diabetes-related lower extremity amputation

IF 3 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Pub Date : 2024-10-22 DOI:10.1111/1753-0407.70011

Jae Won Kim, Kyung-Do Han, Jun Hyeok Kim, Yoon Jae Lee

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Abstract

Background

Foot ulcers are a major complication of diabetes mellitus that increase morbidity and mortality in patients with diabetes, affect their quality of life, and increase the overall social burden. A considerable number of patients with diabetic foot ulcers (DFUs) require amputations every year.

Methods

This nation population–based study included 1 923 483 patients with diabetes who underwent regular health screening through the National Health Insurance Service during January 2009 and December 2012. We investigated the association between changes in physical activity (PA) status and the incidence of lower extremity amputation (LEA). Based on changes in PA status, participants were categorized into four groups: “remained inactive,” “remained active,” “active-to-inactive,” and “inactive-to-active.”

Results

Regular PA is an independent factor associated with a decreased risk of LEA in patients with diabetes. During the follow-up period, 0.23% (n = 4454) of the patients underwent LEA. Compared with the “remained inactive” group, the “remained active” group were at the lowest risk of LEA (adjusted hazard ratio 0.5888; 95% confidence interval 0.524–0.66). A protective effect of regular PA against LEA was observed in the “remaining active” group.

Conclusions

Our findings suggest a protective role of PA against LEA in individuals with diabetes. This highlights the importance of recommending appropriate levels of PA for patients with diabetes. The study also showed a dose–response relationship, indicating that engaging in vigorous-intensity PA was most beneficial, and higher amounts of PA may provide additional benefits.

Abstract Image

查看原文本刊更多论文

定期体育锻炼对糖尿病相关下肢截肢的保护作用。

背景：足部溃疡是糖尿病的主要并发症，会增加糖尿病患者的发病率和死亡率，影响他们的生活质量，并加重整体社会负担。每年都有大量糖尿病足溃疡患者需要截肢：这项以全国人口为基础的研究纳入了 1 923 483 名糖尿病患者，他们在 2009 年 1 月至 2012 年 12 月期间通过国民健康保险服务机构接受了定期健康检查。我们调查了体力活动（PA）状况的变化与下肢截肢（LEA）发生率之间的关系。根据体力活动状况的变化，参与者被分为四组："结果发现，经常进行体力活动是与下肢截肢发生率相关的独立因素：经常进行体育锻炼是降低糖尿病患者LEA风险的一个独立因素。在随访期间，0.23%的患者（n = 4454）接受了LEA。与 "保持不运动 "组相比，"保持运动 "组患 LEA 的风险最低（调整后危险比为 0.5888；95% 置信区间为 0.524-0.66）。在 "保持活跃 "组中，经常进行体育锻炼对LEA具有保护作用：我们的研究结果表明，PA 对糖尿病患者的 LEA 有保护作用。结论：我们的研究结果表明，PA 对糖尿病患者的 LEA 有保护作用，这强调了向糖尿病患者推荐适当水平 PA 的重要性。研究还显示了一种剂量-反应关系，表明进行高强度的体育锻炼最有益，而更高强度的体育锻炼可能会带来更多益处。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Diabetes ENDOCRINOLOGY & METABOLISM-

CiteScore

6.50

自引率

2.20%

发文量

审稿时长

>12 weeks

期刊介绍： Journal of Diabetes (JDB) devotes itself to diabetes research, therapeutics, and education. It aims to involve researchers and practitioners in a dialogue between East and West via all aspects of epidemiology, etiology, pathogenesis, management, complications and prevention of diabetes, including the molecular, biochemical, and physiological aspects of diabetes. The Editorial team is international with a unique mix of Asian and Western participation. The Editors welcome submissions in form of original research articles, images, novel case reports and correspondence, and will solicit reviews, point-counterpoint, commentaries, editorials, news highlights, and educational content.