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Type 2 Diabetes: The More Exercise, the Better

Longer Lives, Healthier Hearts Seen With Higher Activity Levels
WebMD Health News

March 25, 2005 -- Revving up exercise and physical activity could save the hearts and lives of people with type 2 diabetes.

Regular moderate physical activity is recommended for everyone, whether they have diabetes or not. Now, a new study spells out the benefits for people with type 2 diabetes.

"[Heart disease] accounts for more than 75% of total mortality among patients with type 2 diabetes," write the study authors.

Over almost two decades, participants leading the most active lifestyles had lower death rates, including deaths from heart disease.

Being physically active benefited people with type 2 diabetes, protecting them from heart disease regardless of their age, body mass index (BMI), blood pressure, total cholesterol, education, and smoking.

The bottom line: "Regular physical activity can be recommended to patients with diabetes whether or not they have other known [heart disease] risk factors," write the authors.

Hearts at Risk

Heart disease is a leading cause of death for U.S. men and women. Having diabetes increases the risk of heart disease twofold in men and fourfold in women, says the American Diabetes Association.

Obesity, high blood pressure, and abnormal cholesterol levels -- which often accompany diabetes -- only aggravate heart disease trouble.

What does it take to beat those odds? There are many layers to living a healthier life. Setting genetics aside, much of it comes down to habits of daily life. The little decisions we make -- what to eat, whether to smoke, how we handle stress, and much more -- add up over time.

One of those choices -- how much regular physical activity we get -- makes a big difference, says the study. Regular physical activity can help turn underdogs into champs in the battle against heart disease.

The study participants were about 3,700 people with type 2 diabetes. All lived in Finland and were 25-74 years old at the study's start.

They described their level of physical activities, including daily chores, commuting habits, job-related activity, and exercise. Their height, weight, blood pressure, cholesterol, and smoking status were also noted.

Researchers grouped them into low, moderate, or high levels of physical activity and followed them for about 19 years.

During the follow-up period, 1,423 participants died. About 900 deaths were due to heart disease, including 202 deaths from stroke.

Those who reported moderate to high levels of physical activity had a significantly lower risk of death, including death from heart disease. That advantage was "independent of age, education, BMI, blood pressure, total cholesterol, and smoking," says the study.

Digging Deeper

More details were also noted. As expected, smoking, high BMI, and high blood pressure all raised the risk of death (including heart disease death). High cholesterol levels also made heart disease death more likely.

But physical activity was beneficial, no matter how bad those other factors were.

Participants weren't in prime shape at the study's start. Back then, about 45% were obese, 78% had high blood pressure, and 88% had high cholesterol.

The large, long-term study was a plus, say the researchers. But the study also had some limits. First, it relied on participants' reports about their activity levels. Self-reports aren't always accurate.

The researchers also didn't know if participants' activity habits changed over the years. Data were also not available on the severity of participants' diabetes, blood sugar control, and what diabetes drugs they were using.

The results show a pattern, not a causal relationship, say the researchers. Still, they stand by their statement that moderate to high amounts of physical activity may help the hearts and longevity of people with type 2 diabetes.

The report by researchers including Gang Hu, MD, PhD, of Finland's National Public Health Institute appears in the April issue of Diabetes Care.

If you have diabetes and want to enjoy the benefits of physical activity, speak with your doctor first.

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