The Impact of Exercise on All-Cause Mortality Among People With Type 2 Diabetes

Increased exercise capacity is associated with a significantly decreased all-cause mortality risk in individuals with type 2 diabetes, according to new research.¹

The researchers utilized data from 4859 participants of the National Health Interview Survey (NHIS) and the National Health Insurance research database in Taiwan from 2000 to 2016. Included in the study were characteristics about the participants, including socioeconomic status, health behaviors, exercise habits, and comorbitities.

The research team performed statistical analyses in order to examine the relationship between exercise capacity and mortality risk. The results indicated a significantly decreased all-mortality risk of participants who had a greater exercise capacity, with the decrease falling between 25% and 33%.

Consultant360 reached out to the lead study author, Yun-Ju Lai, MD, who is a physician in the Division of Endocrinology and Metabolism at the Puli branch of Taichung Veterans General Hospital in Nantou, Taiwan, about these findings and their implications.

CONSULTANT360: Your study focused on the effect of exercise on all-cause mortality among patients with type 2 diabetes. What knowledge gaps were you hoping to bridge with your analysis?

Yun-Ju Lai: Previous studies had demonstrated that exercise could improve insulin sensitivity and inhibit inflammatory cytokines, thereby reversing the pathogenesis of type 2 diabetes. Epidemiologic studies had also shown that exercise reduced the risk of cardiovascular events and mortality risks. However, the dose of exercise capacity for reducing mortality risk in people with type 2 diabetes was not yet well investigated, especially in the Asian population.

C360: Your study includes a focus on the socioeconomic status, health behaviors, and exercise habits of your participants. Did any combination of risk factors in particular have a greater impact on the all-cause mortality risk?

YJL: The results of multivariable COX regression revealed that subjects who were male, unmarried, had lower socioeconomic status, had current smoking and drinking status, and comorbities including liver cirrhosis, chronic renal failure, stroke, heart failure, and cancer had significantly higher risks of mortality. No significant interactions were noted between exercise capacity and other confounding factors.

C360: How should endocrinologists and other health care providers who manage patients with type 2 diabetes implement your study’s key takeaways into their everyday practice?

YJL: We suggest that people with type 2 diabetes should undergo at least 150 min/week of moderate to vigorous aerobic exercise. For a person who weights 160 lbs (73 kg), exercise capacity equivalent for 800 kcal/week included walking 4 kms/day in a week, bicycling 3 h/week at less than 10 miles per hour, hiking 2 h/week, or running for 1.3 h/week at about 5 mph.

C360: What is the next step in this research?

YJL: We should preform more research to find proper exercise programs, including training mode, frequency, and intensity for people with type 2 diabetes.

Reference:

1. Lai YJ. Association between exercise capacity and all-cause mortality in people with type 2 diabetes. Paper presented at: European Association for the Study of Diabetes; September 21-25, 2020; virtual. https://upload.easd.org/download/EASD2020/Abstract%20Volume%2056th%20EASD%20Annual%20Meeting.pdf