Exercise key to longevity for type 2 diabetics

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Staying active at work and during leisure time may help reduce the risk of death from cardiovascular disease or any other cause for men and women with type 2 diabetes, according to the findings of an international study.

“The benefits of physical activity are consistent in subjects with and without obesity, with and without hypertension, with normal cholesterol and with hypercholesteremia, in subjects who report never smoking or current smoking,” study author Dr. Gang Hu told AMN Health.

"People with diabetes need to look for ways to built activity into their work, their commuting to and from work, and also their leisure time, regardless of their levels of body mass index, blood pressure or cholesterol or smoking,” Hu added.

Researchers expect that type 2 diabetes, a growing public health concern in developed and developing nations, will affect an estimated 366 million individuals in 2030, up from 171 million in 2000.

More than three out of every four people with type 2 diabetes die from cardiovascular disease, but previous studies have shown that a high level of leisure-time physical activity may reduce cardiovascular disease-related deaths, as well as death from any other cause, among these individuals.

Previous studies have not, however, taken into account the combined effect of physical activity and factors that increase a person’s risk of death from cardiovascular disease such as obesity, blood pressure and cholesterol levels.

To investigate, Hu, of the National Public Health Institute in Helsinki, Finland and colleagues followed 3,708 Finnish men and women, 25-to-74 years old, with type 2 diabetes. Over almost 19 years, 1,423 patients died, 906 of cardiovascular disease.

Study participants who reported moderate or high levels of physical activity were less likely to die from cardiovascular disease or from any other cause than less-active adults, the researchers report in the April issue of Diabetes Care. These active individuals included those whose occupation afforded them some type of exercise, including standing, walking or lifting; those whose daily commute involved walking or cycling; and those who participated in light or heavy gardening, running, swimming or other exercise for at least three to four hours during their leisure time.

Physically active adults tended to be younger, weighed less for their height, had lower levels of systolic blood pressure and were less often smokers than were their inactive peers, the report indicates.

Still, moderate or high levels of physical activity reduced the risk of death for men and women of all ages, smokers and nonsmokers alike, regardless of body mass index, blood pressure or cholesterol level—all of which are known to increase a person’s chances of dying of cardiovascular disease.

Thus, “regular physical activity may be more important in mortality risk than many of the traditional CVD risk factors,” Hu and colleagues write.

Research shows that the reduced risk of death among physically active adults may be partly explained decreases blood pressure, increases levels of the “good” HDL cholesterol and weight loss associated with regular exercise. Among diabetics, benefits include improved sensitivity to insulin and better control of blood glucose, the report indicates.

“There is no doubt that physical activity should be considered an integral part of treatment among patients with type 2 diabetes,” the authors conclude.

They add, “regular physical activity can be recommended to patients with diabetes whether or not they have other known CVD risk factors.”

SOURCE: Diabetes Care, April 2005.

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