Physical activity reduces mortality in diabetes patients

Exercise programs for diabetics are a cost-effective treatment and should be reimbursed.


European Association of Preventive Cardiology (EAPC) recommends patients with type 2 diabetes to have a physical activity to control blood sugar and improve heart health. A new study also offers recommendations for doctors on how to motivate patients to incorporate physical activity into their daily routine.

First author Dr. Hareld Kemps, a cardiologist at Máxima Medical Centre, Veldhoven, the Netherlands said, “Sedentary lifestyles and unhealthy diets are the most important drivers of the increasing number of patients with type 2 diabetes and cardiovascular problems such as heart attacks. Diabetes doubles the risk of mortality but the fitter patients become, the more that risk declines. Unfortunately, the majority of patients do not engage in exercise programmes.”

“Just advising patients to exercise, which is what doctors typically do, is not enough. Patients must be assessed for comorbidities, risks related to exercise, and personal preferences. This will be cost effective in the long run so we have to wake up policymakers and healthcare insurers to pay for it. That needs clinicians to take the lead and call for programmes to be reimbursed.”

One of every 11 adults worldwide has diabetes, of which 90% is type 2 diabetes. About all patients with type 2 diabetes create cardiovascular complications, which are the main sources of death in this gathering.

The study also suggests that the patients should visit their doctors for a personalized plan, and those with health insurance should ask if exercise programmes are covered.

Long term adherence can be enhanced by defining early feasible objectives that are quantifiable, and adjusting exercise intend to patients’ inclinations. Remote direction likewise looks encouraging, with patients observing themselves with smartwatches then sending information to a health professional for feedback.

Practical and specific goals tend to be motivational, said Dr. Kemps. “For an elderly person, this could be climbing the stairs in their home or walking to the supermarket – achievements that will really improve their quality of life. Being able to use less medication because of better glycaemic control is also an incentive.”

“As for clinical targets, cardiorespiratory fitness and glycaemic control are the top two. Both improve with exercise training, the changes can be measured, and they are directly related to wellbeing, morbidity, and mortality. Exercise also helps to lower blood pressure and harmful blood lipids.”

Dr. Kemps noted that weight loss might not be the best target for exercise training. “It’s difficult to lose weight with exercise only and if that is the main target patients may become demotivated and stop exercising. Weight loss is important, but it needs to be part of a multidisciplinary intervention that includes nutrition.”

“As for the type and intensity of exercise, this needs to be personalized to each patient. High-intensity interval training – for example alternating moderate and vigorous walking – is most effective at boosting fitness and controlling blood sugar but may be unsafe for patients who develop arrhythmias (abnormal heart rhythm) during exercise or have ischemia (restricted blood flow to the heart).”

D.r Kemps said: “I can’t stress enough how effective even small increases in activity can benefit patients with type 2 diabetes and heart problems. Interrupting sitting with brief bouts of walking improves glucose control, while two hours of brisk walking per week reduces the risk of further heart problems.”

The study is published in the European journal of Preventive Cardiology.