Share on PinterestExercising, even a little, can have profound effects on heart health and overall health. Gary Hershorn/Getty Images
- Research has shown that physical exercise can help increase insulin sensitivity and help regulate blood sugar more effectively in people with diabetes.
- A new study found that people with diabetes who meet current physical activity recommendations through either regular physical activity or a “weekend warrior” type of format have a reduced risk for both all-cause mortality and cardiovascular-related mortality, compared to people who do not exercise.
- Scientists also found that study participants who were insufficiently active still had a lower risk for all-cause and heart disease-related mortality than those who were completely inactive.
According to the International Diabetes Federation, about one in every nine adults around the world is living with diabetes — a chronic condition where the body does not process blood sugar properly.
Of that number, more than 95% of diabetes cases are type 2 diabetes, which is a condition a person develops, compared to type 1 diabetes where a person is born with the disease. People who have obesity, have certain conditions like high blood pressure, and who are not physically active are at a high risk of developing type 2 diabetes.
People with either type of diabetes are at a high risk for health-related complications such as neuropathy, cognitive decline, foot issues, kidney damage, skin conditions, and heart disease.
“People with type 2 diabetes still face a significantly elevated risk of cardiovascular mortality, which is the leading cause of death among this high-risk population,” Zhiyuan Wu, PhD, postdoctoral research fellow in the Department of Nutrition at Harvard School of Public Health, told Medical News Today. “While medication treatments are effective, lifestyle modifications — such as increasing and optimizing physical activity recommendations — are also essential for risk reduction.”
Wu is the first author of a new study recently published in the journal Annals of Internal Medicine that has found people with diabetes who meet current physical activity recommendations through either regular physical activity or a “weekend warrior” type of format have a reduced risk for both all-cause mortality and cardiovascular-related mortality, compared to people who do not exercise.
Scientists also found that study participants who were insufficiently active still had a lower risk for all-cause and heart disease-related mortality than those who were inactive.
Focusing on moderate-to-vigorous exercise
For this study, researchers analyzed health data from more than 51,000 study participants with self-declared diabetes and an average age of about 60 from the National Health Interview Survey (NHIS).
Study participants were broken into four categories based on their moderate-to-vigorous physical activity (MVPA):
- Regularly active with 150 minutes or more of exercise per week over three or more sessions.
- “Weekend warriors” with 150 minutes or more of exercise per week completed in one or two sessions.
- Insufficiently active with less than 150 minutes per week.
- Inactive with reporting no MVPA during the week.
The American Diabetes Association’s (ADA) current recommendations are at least 150 minutes of MVPA per week.
Examples of MVPA include jogging, brisk walking, dancing, hiking uphill, and playing basketball or football.
‘Weekend warrior’ vs. regular physical activity
At the study’s conclusion, researchers found that “weekend warriors” had a 21% lower all-cause mortality risk and 33% lower cardiovascular mortality risk when compared to inactive participants.
Study participants who were regularly active had a 17% lower all-cause mortality risk and 19% lower risk of cardiovascular mortality, when compared to those who did not exercise regularly.
“We found that ‘weekend warriors’ had similar reductions in all-cause and cardiovascular mortality as those who exercised more regularly, as long as they reached the recommended weekly MVPA amount,” Wu explained. “This is important because many people struggle to meet current exercise guidelines that recommend activity spread over multiple days per week.”
“In fact, adherence to current guidelines is under 50% among this population,” he continued. “Our findings suggest that a more flexible approach — like doing 150 minutes of exercise just on weekends — can still provide comparable health benefits and may be easier to stick with for people with busy schedules — demanding work schedules, family responsibilities, or limited access to safe and convenient exercise facilities nearby.”
Insufficient physical activity still better than none
Wu and his team also found that even participants who were insufficiently active still had a lower all-cause and cardiovascular mortality, when compared to inactive participants.
“Our findings show that any amount of physical activity is better than none,” Wu said. “Even participants who didn’t meet the recommended exercise goals still had a lower risk of death compared to those who were completely inactive.”
“This is an encouraging message for people with type 2 diabetes: you don’t have to be perfect to benefit,” he continued. “Simply starting to move — even in small amounts — can make a meaningful difference in your long-term health.”
“The next step is to validate these findings using objective measures of physical activity, such as wearable devices or digital health apps, instead of relying on self-reported questionnaires,” Wu added. “And look into the biological mechanisms, such as host metabolites and proteins, to help explain the similar benefits observed for regular active and ‘weekend warriors’ patterns.”
Physical activity important for people with diabetes
MNT spoke with Cheng-Han Chen, MD, a board certified interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, CA, about this study.
“This prospective cohort study found that exercising at least 150 minutes per week over one to two sessions was associated with a 33% lower risk of cardiovascular mortality in patients with diabetes,” Chen commented. “These results highlight the importance of incorporating physical activity into one’s lifestyle in order to reduce the risk of cardiovascular disease, especially in people with other known risk factors such as diabetes.”
Diabetes and heart health
“Cardiovascular disease is currently the leading cause of death in people with diabetes. It is imperative that we tackle all modifiable risk factors in order to better control the terrible burden that this condition has on our society. We should make all public health efforts to promote regular physical activity in our population.”
— Cheng-Han Chen, MD
1-2 sessions of exercise may be enough to see benefits
MNT also talked to Aaron Feingold, MD, chair of cardiology at JFK University Medical Center in New Jersey, about this research. He commented that his first reaction was one of cautious optimism and practical excitement.
“The finding that weekend warriors — those who concentrate their 150+ minutes of moderate-to-vigorous physical activity into just 1-2 sessions per week — achieved nearly equivalent mortality benefits to those exercising regularly throughout the week is genuinely practice-changing. This challenges the conventional wisdom that exercise must be spread evenly across the week to be maximally beneficial.”
— Aaron Feingold, MD
“For my patients with diabetes who struggle with time constraints, work schedules, or other barriers to frequent exercise, this provides compelling evidence that concentrated weekend activity can still deliver substantial cardiovascular protection, he continued. “Many of my patients express that they simply cannot find time for regular daily exercise due to work, family obligations, or other commitments. By demonstrating that flexible, concentrated exercise patterns can provide similar mortality benefits, we’re expanding the toolkit of evidence-based interventions that can realistically fit into patients’ lives.”
“This research is crucial because cardiovascular disease remains the leading cause of death in patients with diabetes, accounting for approximately 65% of deaths in this population,” Feingold added. “What makes this study particularly valuable is that it addresses real-world barriers to exercise adherence. This is especially important given that lifestyle modifications like physical activity are often more accessible and have fewer side effects than pharmacological interventions.”
