This study was designed to evaluate the link between cycling and mortality from all causes and cardiovascular diseases in diabetic patients. In addition, a link between change in time spent cycling, and the risk of all-cause and cardiovascular disease (CVD) mortality was also examined.


A total of 7459 diabetic people were involved in this prospective cohort research from the European Prospective Investigation into Cancer and Nutrition research. From 1992 to 2000 (baseline examination), questionnaires on medical history, sociodemographic data, and lifestyle information were administered in 10 Western European countries, with a follow-up examination five years later. A total of 5423 diabetic subjects completed both tests. On November 13, 2020, the final updated primary analysis was completed.

All-cause and cardiovascular disease (CVD) mortality, adjusted for other physical activity modalities, diabetes duration, and sociodemographic and lifestyle variables were the primary and secondary outcomes of the study, respectively.


The average (SD) age of the 7459 individuals with diabetes included in the study was 55.9 (7.7) years, with 3924 (52.6%) of them being female. During the follow-up period, 1673 fatalities from all causes were recorded. The multivariable-adjusted hazard ratios for all-cause mortality for cycling 1 to 59, 60 to 149, 150 to 299, and 300 or more min/wk were 0.78 (95% CI, 0.61-0.99), 0.76 (95% CI, 0.65-0.88), 0.68 (95% CI, 0.57-0.82), and 0.76 (95%  CI, 0.63-0.91), respectively, compared to the reference group of people who reported not cycling at baseline. A total of 975 deaths was reported from all causes in a follow up analysis of change in time spent cycling. The adjusted-multivariable hazard ratios for all-cause mortality were 0.90 (95% CI, 0.71-1.14) among those who cycled and then quit, 0.65 (95% CI, 0.46-0.92) in initial noncyclists who started cycling, and 0.65 (95 percent CI, 0.53-0.80) in those who reported cycling at both examinations, compared to people who reported not cycling at both examinations. Similar findings were found in the case of CVD mortality.


Cycling was related to a 24% lower all-cause death risk when compared to noncyclists in this cohort analysis of 7459 diabetics, independent of other physical activity and suspected confounders. When compared to noncyclists, starting cycling over a 5-year period was related with a 35% lower risk of all-cause mortality.


Disease Condition,Risk factors-comorbidities,Cardiovascular diabetes,Exercise and Sports,Diabetes and Heart disorders,DCDM_others,Exercise,Sports