The associations were largely consistent and significant among individuals from different socioeconomic background s and baseline characteristics .
Conclusions /interpretationAdoption of a healthy lifestyle is associated with substantial risk reduction in type 2 diabetes and long-term adverse outcomes among diabetic individuals .
Aims /hypothesisA healthy lifestyle has been widely recommended for the prevention and management of type 2 diabetes .
However , no systematic review has summarised the relationship between combined lifestyle factors ( including , but not limited to , smoking , alcohol drinking , physical activity , diet and being overweight or obese ) and  incident type 2 diabetes and risk of health outcomes among diabetic individuals .
Lifestyle factors and mortality among adults with diabetes: findings from the European Prospective Investigation into Cancer and Nutrition-Potsdam study*.
BACKGROUND Healthy lifestyle behaviors are among the cornerstones of diabetes self-management , but the extent to which healthy lifestyle factors could potentially prevent premature mortality among people with diabetes remains unknown . The aim of the present study was to estimate the reduction in mortality that could be achieved if people with diabetes did not smoke , had a body mass index < 30 kg/m(2 ) , performed physical activity for ≥3.5 h/week , reported better dietary habits , and consumed alcohol moderately . METHODS A prospect i ve cohort study of 1263 German men and women with diabetes aged 35 - 65 years who were followed for an average of 7.8 years was used and multivariate Cox regression models for all-cause and cause-specific mortality were calculated . RESULTS Approximately 7 % of study participants had no favorable factors , 24 % had one , 35 % had two , and 34 % had three or more . Compared with participants who had no favorable factors , the reduction in risk was 34 % [ 95 % confidence interval ( CI ) 19 % , 63 % ] for those with one favorable factor , 49 % ( 95 % CI 9 % , 71 % ) for those with two , and 63 % ( 95 % CI 31 % , 80 % ) for those with three or more . Furthermore , a competing risk analysis did not show any difference in the inverse associations with mortality due to cardiovascular disease , cancer , or other causes . CONCLUSIONS Favorable lifestyle factors can potentially achieve substantial reductions in premature mortality among people with diabetes . Our results emphasize the importance of helping people with diabetes optimize their lifestyle behaviors
The associations were largely consistent and significant among individuals from different socioeconomic background s and baseline characteristics .
Conclusions /interpretationAdoption of a healthy lifestyle is associated with substantial risk reduction in type 2 diabetes and long-term adverse outcomes among diabetic individuals .
Aims /hypothesisA healthy lifestyle has been widely recommended for the prevention and management of type 2 diabetes .
However , no systematic review has summarised the relationship between combined lifestyle factors ( including , but not limited to , smoking , alcohol drinking , physical activity , diet and being overweight or obese ) and  incident type 2 diabetes and risk of health outcomes among diabetic individuals .