Increased Physical Activity and CVD Risk in Adults With Type 2 Diabetes

woman going for a run
Researchers examined whether changes in physical activity affected risk for cardiovascular disease outcomes in patients with type 2 diabetes.

To reduce risk for cardiovascular disease (CVD), long-term moderate to vigorous physical activity (MVPA) may be beneficial for adults with obesity and type 2 diabetes, according to study results published in Diabetes Care.

Researchers conducted a post hoc analysis from a multicenter, randomized controlled trial (Look AHEAD; Identifier: NCT00017953) to examine if changes in physical activity, measured by accelerometry and self-reporting over a 4-year period, were associated with a lower risk for CVD outcomes.

A total of1978 adult participants, aged from 45 to 76 years, with a body mass index of 25 and higher (considered overweight) or 27 and higher (considered obese) and had type 2 diabetes, were randomly assigned to an intensive lifestyle intervention (ILI) cohort or a diabetes support and education (DSE) cohort.

The ILI cohort included a combination of individual and group sessions, conducted by e-mail or telephone, and motivational and refresher campaigns. The dietary intervention was focused on reducing energy intake to 1,200 to 1,800 kcal/day, with a maximum dietary fat intake prescribed at 30% of total energy intake, with 10% consumed as saturated fat. Participants were instructed to progressively increase nonsupervised physical activity from 50 min/week to at least 175 min/week by week 26 of the intervention. The DSE group were offered group sessions focused on physical activity, diet, and social support. Medical care and diabetes treatment continued for participants in both groups.

Study results showed that an ILI was not more effective at decreasing CVD outcomes than DSE. However, persons whose body weight reduced by 10% and more had lower risk for CVD. Researchers also noted  that approximately 30 minutes of brisk walking a week from baseline to year 4 was associated with a 5% to 10% decrease in risk for CVD mortality, nonfatal myocardial infarction, and stroke in patients with type 2 diabetes with overweight or obesity.

Researchers noted their study was limited by not being based on prespecified data analysis and by self-report of physical activity, which may not have been as sensitive as physical activity reported by accelerometry.

The researchers stated, “To improve the risk of CVD for persons with overweight/obesity and type 2 diabetes, increasing MVPA may need to be viewed as not simply a short-term change in behavior but as an ongoing commitment to a physically active lifestyle.”

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.


Jakicic JM, Berkowitz RI, Bolin P, et al on behalf of the Look AHEAD Study Group. Association between change in accelerometer-measured and self-reported physical activity and cardiovascular disease in the Look AHEAD trialDiabetes Care. Published online January 10, 2022. doi:10.2337/dc21-1206