Introduction

Diabetes carries the risk of serious complications, including a higher-than-normal risk of developing cardiovascular disease. For those with type 2 diabetes, an ailment that is becoming increasingly common in overweight, sedentary adults, the diagnosis is often a "wake up" call to improve their diet and exercise habits. A study in a recent issue of the Annals of Internal Medicine underscores the importance of regular exercise in the management of type 2 diabetes.

Exercise makes a difference

Researchers at Harvard School of Public Health asked over 5,000 middle-aged women with type 2 diabetes to keep track of how much and what kinds of rigorous exercise-sports, brisk walking, biking, strenuous gardening or housework-they did over a 14-year period. They found that women who engaged in moderate to vigorous exercise at least 4 hours per week were almost 40% less likely to develop heart disease when compared with more sedentary women.

Since walking was the exercise of choice for so many of the women, the researchers took a closer look at how walking speed affected the women's heart health. A brisk walking pace of at least 4 miles per hour afforded the most health benefits, but those who kept up an "average" pace (about 3 mph) also were significantly less likely to develop heart disease when compared to those who walked more slowly.

As is often the case in studies like this one, the women who were most active practiced other good health habits as well. Those who exercised regularly were generally leaner than non-exercisers. They were also less likely to smoke and more likely than other study participants to take vitamin supplements, especially vitamin E. Even after accounting for the effects of all these other healthy habits, though, exercise still had a significant impact on the women's risk of cardiovascular disease.

Action step

The American Diabetes Association urges everyone with diabetes to work physical activity into his or her daily schedule. This advice is particularly directed toward those with type 2 diabetes, the majority of who are overweight. Regular exercise can help control blood sugar and, as this study illustrates, reduce the risk of cardiovascular disease, the leading cause of death in people with diabetes.

They advice novice exercisers to first check with their healthcare provider, and then begin slowly-a 15 minutes walk around the block is a good place to start-and make sure to dress for the weather and wear well-fitting shoes. For those who are physically able, a good goal is to aim for 30 minutes of exercise on most days.