Study Finds Increased Exercise Lowers Mortality Risk 25-32% Among Diabetics

New data from a team of investigators in Taiwan is underlining the importance of physical activity and exercise for long-term survival in patients with type 2 diabetes.

Presented at the European Association for the Study of Diabetes (EASD) 2020 Annual Meeting, the analysis of more than 4500 patients over a 15-year period suggests greater levels of exercise was linked to a 25-32% reduction in risk of all-cause mortality among patients with type 2 diabetes.

"Among people with type 2 diabetes, those with increased exercise capacity had a significantly decreased risk of all-cause mortality. Further studies should investigate the type and dose of exercise that is most helpful to promote health and prolong life expectancy,” wrote study investigators.

While many studies have examined the effects of exercise in diabetics, investigators noted few had examined associations between exercise capacity and all-cause mortality. To provide further information on this subject, investigators from the Taichung Veterans General Hospital in Taiwan designed their study as an analysis of data from the National Health Interview Survey (NHIS) and the National Health Insurance research databases.

As part of NHIS, patients underwent standardized face-to-face interviews in 2001, 2005, 2009, and 2013. Through a search of the National Health Insurance research database from 2000-2016, investigators were able to confirm comorbidities for each patient and, from the National Registration of Death, investigators were able to ascertain instances of mortality.

Investigators identified a total of 4859 adult participants with type 2 diabetes for their study. Of these, 49.15% (n=2389) were men and the cohort had a mean age of 59.5 (12.63) years. Using Kaplan-Meier curves, of all-cause mortality stratified by exercise capacity, investigators unveiled significant findings. In univariate Cox regression analysis, investigators found those with higher exercise capacity had a significantly decreased risk of all-cause mortality compared to those with no exercise habits (moderate exercise with 0-800 kcal/week HR, 0.83; 95% CI, 0.71-0.97, high exercise with more than 800 kcal/week HR, 0.77; 95% CI, 0.67-0.89).

After adjustment for potential confounders, a multivariate Cox regression analysis indicated those with a higher exercise capacity was associated with a significantly decreased risk of all-cause mortality compared to those with no exercise habits (moderate exercise with 0-800 kcal/week: HR, 0.75, 95% CI: 0.62-0.91, high exercise with more than 800 kcal/week: HR, 0.68, 95% CI, 0.57-0.81). Additionally, investigators noted a significant trend (P for trend <.01).

In a sensitivity analysis excluding mortality in the first and second year in the study period, results suggest those with increased exercise capacity had a significantly decreased risk of all-cause mortality.

This study, “Association between exercise capacity and all-cause mortality in people with type 2 diabetes,” was presented at EASD 2020.