Diabetics live longer with physical exercise

Exercise reduces your chances of developing type-2 diabetes, but even if you already have diabetes exercise is good for you. Definitely if you exercise for longer than the daily half hour that is advised.

At the Lawrence Berkeley National Laboratory, the biostatistician Paul Williams examined data gathered in the National Walkers’ and Runners’ Health Studies. In that project researchers have been following several hundred thousand runners and walkers since the twentieth century – and among them are 2160 men and women who take medication for diabetes.

Williams knew how often the participants walked and ran, and divided them into three groups on the basis of the amount of calories they burned. The first group did the equivalent of 1.07 MET-hours per day. 1 MET-hour is the equivalent of about 1 km running or 1.5 km walking at a brisk pace.

The second group did between 1.07 and 1.8 MET-hours a day. If you manage the 1.8 MET-hours per day, you do exactly the amount of exercise that health experts advise. That means walking briskly for a good half hour every day.

The third group that Williams separated out were those who did more than the 1.8 MET-hours per day, and thus got more exercise than advised.

When Williams then looked at which diabetics had died, he saw that their mortality risk was lower, the higher their MET-hour figure was. In the figure below the mortality risk of the diabetics category with the least exercise.

Diabetics are more likely to die, and this is mainly because the disease damages the heart and blood vessels. Williams discovered that walking and running reduced the risk of dying from cardiovascular disease. In addition, exercise also reduced the chance of dying from an infectious disease or a kidney disease.

“Most people at risk for diabetes are not sufficiently active as defined by the recommendations for the general population, little less the recommendations for diabetic patients”, Williams concludes. “These results identify important additional benefits for diabetic patients to exceed the current general physical activity recommendations for adults.

Reduced Total and Cause-Specific Mortality from Walking and Running in Diabetes

This study aimed to assess the relationships of running and walking to mortality in diabetic subjects.

We studied the mortality surveillance between January 1, 1989 and December 31, 2008, of 2160 participants of the National Walkers’ and Runners’ Health Studies who reported using diabetic medications at baseline. Hazard ratios (HR) and 95% confidence intervals (95% CI) were obtained from Cox proportional hazard analyses for mortality versus exercise energy expenditure (MET-hours per day, 1 MET·h ?1-km run or a 1.5-km brisk walk).

Three hundred and thirty-one diabetic individuals died during a 9.8-yr average follow-up. Merely meeting the current exercise recommendations was not associated with lower all-cause mortality (P = 0.61), whereas exceeding the recommendations was associated with lower all-cause mortality (HR = 0.64, 95% CI = 0.49–0.82, P = 0.0005). Greater MET-hours per day ran or walked was associated with 40% lower risk for all chronic kidney disease-related deaths (HR = 0.60 per MET·h·d?1, 95% CI = 0.35–0.91, P = 0.02), 31% lower risk for all sepsis-related deaths (HR = 0.69, 0.47–0.94, P = 0.01), and 31% lower risk for all pneumonia and influenza-related deaths (HR = 0.69, 95% CI = 0.45–0.97, P = 0.03). Running or walking ?1.8 MET·h·d?1 was associated with 57% reduction in cardiovascular disease (CVD) as an underlying cause of death and 46% lower risk for all CVD-related deaths versus <1 .07="" d="" h="" met="" nbsp="" p="">
All results remained significant:

1. adjusted for baseline BMI and 
2. excluding all deaths within 3 yr of baseline.

These results suggest that

1.  exercise is associated with significantly lower all-cause, CVD, chronic kidney disease, sepsis, and pneumonia, and influenza mortality in diabetic patients and:
2. higher exercise standards may be warranted for diabetic patients than currently provided to the general population.