Issue 162 Item 5 Walking Increases Longevity in Diabetics, Even When Comorbiditi

Walking at least a few hours per week appears to decrease mortality across a wide spectrum of adults with diabetes, researchers at the Centers for Disease Control Announced.

Previous studies of physical activity among persons with diabetes included subjects who were "younger and likely healthier than the general diabetic population," Dr. Edward W. Gregg and associates point out in the Archives of Internal Medicine for June 23. To address a more representative cohort, they examined data from the National Health Interview Survey.

The 2896-member cohort was interviewed in 1990 and 1991 and mortality was assessed during the next 8 years. Persons considered disabled were not included in the analysis. Ages ranged from 18 to 95 years with an average time since diabetes diagnosis of 11.0 years. Nearly a third reported a history of heart disease, and almost half had a limitation in daily function.

Compared with subjects who reported no walking, those who walked at least 2 hours per week had a 39% lower all-cause mortality rate and a 34% reduced cardiovascular disease mortality risk, after controlling for age, gender, ethnicity, body mass index, smoking and comorbid conditions.

"Thus, among diabetic adults, one death per year may be preventable for every 61 people who could be persuaded to walk at least 2 hours/week," Dr. Gregg’s team estimates. Risk reduction was greatest among those who reported moderate increases in heart rate or breathing while walking.

"Because of the high prevalence of underlying ischemic heart disease and the augmented risk of joint-related injuries, adoption of a moderate, rather than a vigorous, activity program may be more suitable for diabetic patients," Drs. Frank B. Hu and JoAnn E. Manson note in an accompanying editorial, and precautions should be taken to minimize exercise-induced hypoglycemia.

"Walking is probably the ‘best medicine’ for both prevention and treatment of diabetes mellitus," conclude the physicians from the Harvard School of Public Health in Boston. Arch Intern Med 2003;163:1397-1398,1440-1447.

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