Walking Found To Help Diabetics Live Healthier

Study Shows Increased Life Span

Individuals with diabetes will probably live longer simply by strolling, a new report in the Archives of Internal Medicine indicates.

An analysis of 2,900 adults who had diabetes for an average of 11 years found that even two hours of walking weekly reduced the risk of death by 39 percent.

Included in that reduction was a 34 percent decrease in risk of death from cardiovascular disease, to which diabetics are particularly prone.

Not Just Healthier, But Living Longer

"This is the first study to look at a nationally representative sample of people with diabetes," says Dr. Edward Gregg, an epidemiologist with the Centers for Disease Control and Prevention (CDC), who conducted the analysis and prepared the report.

"Other studies have found that people are less likely to get new diseases if they walk, but we found that walking will increase the length of life once people have diabetes," Dr. Gregg says.

This is particularly important, Dr. Gregg adds, because of the incidence of the disease.

"Diabetes is one of the most common chronic illnesses; the ratio in people 60 and older is one out of five or one out of six," he explains. "But even though the disease increases the risk for death, most people with diabetes will go on to live for a long time.

"So one of the key things to do is improve the quality of life, and walking will increase the length of life once people have diabetes," Dr. Gregg says.

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and the American Diabetes Association:

Diabetes affects an estimated 17 million people in the US (90 to 95 percent have type 2 diabetes). Of these individuals, 11.1 million have been diagnosed, but 5.9 million are unaware they have the disease.

For the analysis, Dr. Gregg and his colleagues at the CDC used data from the 1990-1991 National Health Interview Survey (NHIS) to look at the mortality rates for 2,896 diabetics who had been sick for an average of 11 years. Their average age was 59. In an eight-year follow up, 671 of the participants died, 316 of those deaths were heart disease related.

Study Takes a Close Look at Exercise Patterns

Looking at the health interviews that were conducted in the early 1990s, including self-reports of exercise among all the participants, the scientists found that those diabetics who walked for at least two hours weekly had a 39 percent lower death rate from all causes and a 34 percent lower death rate from heart disease compared to those who did not walk.

Among those who walked between three and four hours a week, the benefit was even higher, with a 53 percent lower death rate from cardiovascular disease. Walking any longer than that did not result in further benefit, however, the study points out.

Dr. Frank Hu, a diabetes specialist at the Harvard School of Public Health who wrote an editorial that accompanied the study, says the CDC study confirms that walking is an important part of treating diabetes.

"Lifestyle modifications remain a cornerstone for diabetic management," Dr. Hu says. "We have very strong evidence that walking and other types of activity can go a long way in reducing mortality and cardiovascular complications from diabetes. Walking is as effective as medicines - probably more effective, because walking has no side effects."

Always consult your physician for more information.

Treatment for Diabetes

Specific treatment for diabetes will be determined by your physician based on:

Treatment may include:

type 1 diabetes
Persons with type 1 diabetes no longer produce insulin, and they must have insulin injections to use the glucose they obtain from eating.
Persons with type 1 diabetes must give themselves insulin every day. Insulin can either be injected, which involves the use of a needle and syringe, or it can be given by an external or internal insulin pump, insulin pen, jet injector, or insulin patch. Extra amounts of insulin may be taken before meals, depending on the blood glucose level and food to be eaten.

Insulin cannot be taken as a pill. Because it is a protein, it would be broken down during digestion just like the protein in food. It must be injected into the fat under the skin for insulin to get into the blood. The amount of insulin needed depends on height, weight, age, food intake, and activity level. Insulin doses must be balanced with meal times and activities, and dosage levels can be affected by illness, stress, or unexpected events.

type 2 diabetes
Although persons with type 2 diabetes may continue to produce adequate insulin for some time, their bodies can become incapable of using it. This syndrome is know as insulin resistance, and may indicate the need for oral medications that can help stimulate the pancreas to release insulin or optimize the body's ability to use the insulin secreted.

Diet and exercise can often bring blood glucose levels down to normal. When these measures are no longer enough, the next step is the addition of medications that lower blood glucose levels.

There are many considerations a person with diabetes must take in order to properly manage his/her condition.

Always consult your physician for more information.

August 2003

Walking Found To Help Diabetics Live Healthier

Not Just Healthier, But Living Longer

Study Takes a Close Look at Exercise Patterns

Treatment for Diabetes

Statins Slash Heart Disease Risk for Diabetics

Online Resources

Statins Slash Heart Disease Risk for Diabetics

Supporting statins' growing status as the aspirin of the 21st century, a new study shows this medication can slash the risk of strokes, heart attacks, and other cardiovascular problems in diabetics - even if they do not have high cholesterol.

The study, reported in the medical journal The Lancet, found giving these cholesterol-lowering drugs to people with diabetes cut their risk of heart and vessel trouble by about 25 percent.

The benefits of lowering cholesterol were strong for both those with the blood sugar disease but no warning signs of cardiovascular illness and those whose "bad" cholesterol fell in the accepted normal range.

That is not surprising, the researchers say, because very few people in industrialized countries have "normal" cholesterol.

"We've all got levels that are too high, and this study demonstrates that absolutely unequivocally," says research leader Dr. Rory Collins, of the University of Oxford, England.

An estimated 100 million people worldwide have diabetes, putting them at increased risk for heart attacks and strokes.

If each of them were to take statins routinely, Dr. Collins says, as many as 1 million of these life-threatening events could be prevented each year.

"The logical conclusion is to think about statins in the way we think about aspirin," Dr. Collins says. "Now we've got unequivocal evidence that in people at high risk [for heart and vessel disease], by lowering their cholesterol we will lower their risk, irrespective of how low their cholesterol is to begin with."

Dr. Collins' group compared the effects of routine statin use and no therapy in more than 20,000 Britons. Of those, roughly 6,000 had diabetes - mostly the adult-onset, or type 2, form of the condition - while the rest had varying degrees of blocked arteries but no blood sugar problems.

Half the volunteers were given 40 milligrams a day of the drug simvastatin, sold as Zocor® by Merck & Co., which helped fund the study. Half were given a placebo, or inactive pill.

Over the next five years, 601 diabetics taking the statin suffered a first-time heart attack or stroke, or required procedures to correct vessel blockages. The figure was 748 in the group on placebo - a difference of 22 percent. For those who had already had one of these events, the cholesterol drug significantly reduced their chances of suffering a repeat attack.

In the 2,900 diabetics without blocked blood vessels at the start of the trial, the reduction was even greater: 33 percent fewer people in this group developed heart or vessel problems.

And, among diabetics with low-density lipoprotein (LDL), the dangerous form of cholesterol, that was not high, taking the daily statin dropped their risk of developing cardiovascular trouble by 27 percent compared with those on placebo.

Dr. Collins says the benefits of the drug persisted even in diabetics with LDL counts of 80 milligrams per deciliter of blood, a figure generally thought to be excellent.

"Our hypothesis was that irrespective of where you started in terms of your LDL cholesterol, lowering it by the same absolute amount - an average of 40 milligrams per deciliter - should reduce the risk of [heart and vessel problems] by the same proportion," Dr. Collins says.

Always consult your physician for more information.

Online Resources

(Our Organization is not responsible for the content of Internet sites.)

American Diabetes Association

American Heart Association

Centers for Disease Control and Prevention (CDC)

Diabetes Care

Healthier US.Gov

National Diabetes Education Program

National Heart, Lung, and Blood Institute (NHLBI)

National Institute of Diabetes & Digestive & Kidney Diseases (NIDDKD)

National Institutes of Health (NIH