Abstract 13759: Adherence to Healthy Lifestyle is Associated With Lower Total and Cause-Specific Mortality Risk Among Patients With Diabetes: The UK Biobank Study

Abstract

Introduction: The association of an overall healthy lifestyle, involving 3 emerging factors (less sedentary time, adequate sleep duration, appropriate social connection) and 4 conventional factors (no current smoking, moderate alcohol consumption, regular physical activity, healthy diet) from the prevailing diabetes management guideline, with total and cause-specific mortality risk in patients with diabetes remains to be examined. Hypothesis: We hypothesized that an overall healthy lifestyle would be associated with a lower risk of total and cause-specific mortality in patients with diabetes. Methods: Analyses included 18,822 participants with diabetes at baseline in the UK Biobank. Lifestyle information was collected via a baseline questionnaire (2006-2010). Cox proportional hazard modeling was used to examine the association of a healthy lifestyle with mortality risk. Results: During a median follow-up of 11.2 years, 2,470 deaths occurred after 2 years of enrollment. The fully-adjusted hazard ratios (95% CIs) for patients with 6-7 low-risk lifestyle factors compared with those with 0-2 were 0.44 (0.38-0.51) for total mortality, 0.52 (0.40-0.67) for cancer mortality, 0.38 (0.26-0.56) for CVD mortality, 0.24 (0.13-0.45) for respiratory disease mortality, 0.96 (0.45-2.04) for neurodegenerative disease mortality, and 0.16 (0.04-0.62) for digestive system disease mortality. For each additional low-risk factor, the risk was 17% lower for total mortality and 13-26% lower for cause-specific mortality. The association for a summed score of the emerging factors was stronger in those with a lower score of conventional factors (P-interaction <0.05). The inverse association between a healthy lifestyle and total mortality risk was consistently observed regardless of diabetes duration, vascular disease, glycemic control, and diabetes medication. Besides, the association was stronger in those with earlier diabetes onset or lower socioeconomic status (both P-interaction <0.05). Conclusions: For patients with diabetes, a healthy lifestyle is associated with a lower risk of total and most cause-specific mortality. Our findings are consistent across sub-populations, especially for those differing in factors related to diabetes severity.