Abstract

Abstract Lifestyle changes after a diagnosis of type 2 diabetes mellitus (T2DM) can affect vascular health outcomes. The objective of this study was to investigate the effects of changes in smoking and exercise on the risk of cardiovascular disease (CVD) and mortality in patients with newly diagnosed T2DM. Data were analyzed for 181,591 people with newly diagnosed T2DM who underwent 2 serial health examinations within 2 years before and after diagnosis of diabetes. The study population was followed from the baseline to the date of death or cardiovascular events, or until December 31, 2018 and median follow-up was 6. 07 years. Based on the change in status from before to after the diagnosis of T2DM, participants were grouped into smoking groups (continuous smokers, quitters, new smokers, and nonsmokers) and exercise groups (constant exercisers, new exercisers, exercise dropouts, and non-exercisers). Compared with the non-exercisers, those who initiated exercise after their diagnosis had a lower risk of myocardial infarction (MI), stroke, and all-cause mortality: the hazard ratio (HR; 95% confidence interval [CI]) was 0.85 (0.76–0.94) for MI, 0.86 (0.78–0.94) for stroke, and 0.84 (0.89–0.90) for all-cause mortality. Quitters had a higher risk of MI, stroke, and all-cause mortality than nonsmokers, but their risk level was much lower than that in continuous smokers. Whenthe group ofcontinuous smokers and non-exercisers was considered as the reference group,participants who quit smoking and remained non-exercisers had a 21% lower risk of CVD (HR 0.79; 95% CI 0.70–0.90). Those who quit smoking and started exercising had a 46% reduced risk of CVD (HR 0.54; 95% CI 0.41–0.71) and a 22% reduced risk in all-cause mortality (HR 0.78; 95% CI 0.63–0.96). Smoking cessation and exercise initiation after a diagnosis of new-onset T2DM was associated with a reduced risk of CVD and all-cause mortality. Presentation: No date and time listed

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