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A total of 1612 individuals with type 1 diabetes were recruited, and LTPA was assessed at baseline using a validated self-report questionnaire. Severe diabetic retinopathy was defined as the initiation of laser treatment due to severe nonproliferative, proliferative retinopathy or diabetic maculopathy (identified from the Care Register for Health Care).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 261 patients received laser treatment during the follow-up. Higher frequency of LTPA was associated with a lower incidence of severe diabetic retinopathy (<jats:italic>p<\/jats:italic>\u2009=\u20090.024), a finding that remained significant after adjustment for gender, duration, age at onset of diabetes, kidney function, BMI, triglycerides and systolic blood pressure. However, when HbA<jats:sub>1c<\/jats:sub>and smoking were added to the Cox regression model the association was no more significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Frequent LTPA is associated with a lower incidence of severe diabetic retinopathy during the follow-up. The total amount or the other components of LTPA (intensity or duration of a single session) were not associated with severe diabetic retinopathy.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00592-019-01454-y","type":"journal-article","created":{"date-parts":[[2019,11,20]],"date-time":"2019-11-20T06:04:15Z","timestamp":1574229855000},"page":"527-534","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Frequent physical activity is associated with reduced risk of severe diabetic retinopathy in type 1 diabetes"],"prefix":"10.1007","volume":"57","author":[{"name":"the FinnDiane Study Group","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi","family":"Tikkanen-Dolenc","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan","family":"Wad\u00e9n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol","family":"Forsblom","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valma","family":"Harjutsalo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lena M.","family":"Thorn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markku","family":"Saraheimo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"Elonen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kustaa","family":"Hietala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Summanen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heikki O.","family":"Tikkanen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4055-6954","authenticated-orcid":false,"given":"Per-Henrik","family":"Groop","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,11,20]]},"reference":[{"key":"1454_CR1","doi-asserted-by":"publisher","first-page":"271","DOI":"10.2337\/diab.33.3.271","volume":"33","author":"J Dorman","year":"1984","unstructured":"Dorman J, Laporte R, Kuller L et al (1984) Pittsburgh insulin-dependent diabetes mellitus morbidity and mortality study: physical activity and diabetic complications. 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No other potential conflicts of interest relevant to this article were reported.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The study protocol was approved by the Ethical Committee of the Helsinki and Uusimaa Hospital District as well as by the local ethics committees at the participating centres and conducted according to the Declaration of Helsinki.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"The study protocol was approved by the Ethical Committee of the Helsinki and Uusimaa Hospital District as well as by the local ethics committees at the participating centres and conducted according to the Declaration of Helsinki.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Human and animal rights disclosure"}},{"value":"Before participation, all patients gave their written informed consent.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}