A healthy lifestyle pattern and mortality risk in patients of type 2 diabetes mellitus: a prospective cohort study in China

This study aimed to evaluate the association of a healthy lifestyle pattern with mortality risk among patients with type 2 diabetes mellitus (T2DM). Data were derived from a prospective cohort enrolling 13,776 Chinese patients with T2DM. A healthy lifestyle pattern was constructed based on six lifestyle factors, including smoking, alcohol consumption, dietary habit, physical activity, sedentary time, and sleep duration. Multivariate Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause and cause-specific mortality. During a median follow-up of 9.0 years, 2,497 deaths were recorded. Compared to T2DM patients with the lifestyle pattern scoring 0-2, those scoring 5-6 had a 40% lower risk for all-cause mortality (HR = 0.60, 95% CI: 0.52-0.69), 33% lower risk for CVD mortality (HR = 0.67, 95% CI: 0.52-0.69), and 25% lower risk for cancer mortality (HR = 0.75, 95% CI: 0.58-0.97). In addition, we found that the association between the lifestyle pattern and all-cause mortality risk was stronger in females than in males (P for interaction < 0.05). In conclusion, adherence to a healthy lifestyle pattern is associated with a decreased risk of all-cause, CVD, and cancer mortality, which has important implications for reducing premature mortality in patients with T2DM.