Can Curbing Sedentary Habits Mitigate Mortality Risk in T2D?



A low physical activity level combined with < 6 hours daily of sedentary time reduces the risk for all-cause and cardiovascular mortality in patients with type 2 diabetes (T2D), whereas only moderate physical activity benefits those sedentary for ≥ 6 hours each day.


  • Understanding how sedentary behavior and physical activity affect mortality in patients with T2D may highlight lifestyle interventions that can improve diabetes prognosis.
  • Researchers evaluated the combined effect of physical activity and sedentary behavior on mortality in 6136 patients with T2D (average age, 59.45 years; 51.48% men) over an average 6-year follow-up using the National Health and Nutrition Examination Survey (NHANES) data collected from 2007 to 2018.
  • Sedentary behavior was classified into low (< 6 h/d) and high (≥ 6 h/d) levels and physical activity levels as none (totally sedentary behavior), low, moderate, and high, as determined using metabolic equivalent values.
  • Participants were further classified into eight subgroups by combining low or high sedentary behavior with low, moderate, or high physical activity levels, and total sedentary behavior (high or low) was used as reference.
  • The all-cause and cardiovascular mortality statuses were determined using the NHANES data.


  • The risks for all-cause mortality and cardiovascular mortality were 64% (hazard ratio [HR], 1.64; P < .01) and 66% (HR, 1.66; P = .03) higher, respectively, in the high sedentary behavior group than in the low sedentary behavior group.
  • The risk for all-cause mortality was reduced in the low (HR, 0.58), moderate (HR, 0.60), and high (HR, 0.51; P < .05 for all) physical activity groups, whereas the risk for cardiovascular mortality was significantly reduced only in the moderate physical activity group (HR, 0.45; P < .05) compared with the total sedentary behavior group.
  • The risk for all-cause and cardiovascular mortality was lower in patients having a low physical activity level with short sedentary time, and the risk did not reduce further with increased physical activity levels.
  • In patients with longer sedentary times, only moderate physical activity led to a reduced risk for all-cause mortality.


“These findings may give us a perspective in clinical practice that lifestyle interventions for patients with diabetes should optimize the level of PA [physical activity] according to their SB [sedentary behavior] patterns to improve the prognosis,” wrote the authors.


The study, led by Jieyi Liu, Department of Cardiology, Guangdong Provincial Key Laboratory of Cardiac Function and Microcirculation, Nanfang Hospital, Southern Medical University, Guangzhou, China, was published in The Journal of Clinical Endocrinology & Metabolism.


The study did not report any limitations.


The study was supported by the National Natural Science Foundation of China, China Postdoctoral Science Foundation, and Municipal Project of Research and Utilization of Healthcare Key Technology in Guangzhou, China. The authors declared no conflicts of interest.


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