Article Impact Level: HIGH Data Quality: STRONG Summary of The Lancet, S0140673625012401. https://doi.org/10.1016/S0140-6736(25)01240-1 Dr. Angela E. Apeagyei et al.
Points
- This prospective cohort study analyzed survey data from over 51,000 adults with diabetes to evaluate the impact of different exercise patterns on mortality over a median 9.5-year follow-up.
- Participants were categorized into four groups based on their weekly moderate-to-vigorous activity patterns, including inactive, insufficiently active, weekend warrior, and regularly active groups, all of which met the current guidelines.
- Compared to being inactive, both weekend warriors and regularly active individuals showed significantly lower all-cause mortality, with hazard ratios of 0.79 and 0.83, respectively.
- The benefits were most substantial for cardiovascular mortality, where weekend warriors and regularly active participants had 33% and 19% lower risk of death compared to inactive individuals.
- These findings suggest the total amount of physical activity, rather than its weekly frequency, is key to reducing mortality risk in adults living with diabetes.
Summary
This prospective cohort study aimed to investigate the relationship between various physical activity patterns and mortality in adults with diabetes. Researchers analyzed data from 51,650 U.S. adults with self-reported diabetes who participated in the National Health Interview Survey (1997-2018), with mortality data tracked through December 31, 2019. Participants were categorized as inactive, insufficiently active (MVPA < 150 minutes/week), weekend warriors (MVPA ≥ 150 minutes/week in 1-2 sessions), or regularly active (MVPA ≥ 150 minutes/week in ≥3 sessions). The study’s primary limitation was its reliance on self-reported physical activity assessed at a single time point.
Over a median follow-up of 9.5 years, 16,345 deaths were recorded. Compared with the inactive group, multivariable-adjusted hazard ratios (HRs) for all-cause mortality were significantly lower for the insufficiently active (HR, 0.90 [95% CI, 0.85 to 0.95]), weekend warrior (HR, 0.79 [CI, 0.69 to 0.91]), and regularly active groups (HR, 0.83 [CI, 0.78 to 0.87]). These reductions were driven primarily by lower cardiovascular mortality, with HRs of 0.67 (CI, 0.52 to 0.86) for weekend warriors and 0.81 (CI, 0.74 to 0.88) for the regularly active group.
The association with cancer mortality was less pronounced. The HR for weekend warriors was 0.99 (CI, 0.76 to 1.30), while the regularly active group had an HR of 0.85 (CI, 0.75 to 0.96). In conclusion, both weekend warrior and regularly active patterns meeting current guidelines were associated with substantially lower risks for all-cause (21% and 17% lower, respectively) and cardiovascular mortality (33% and 19% lower, respectively) among adults with diabetes, underscoring that any pattern of sufficient physical activity is beneficial.
Link to the article: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)01240-1/abstract
References Apeagyei, A. E., Bisignano, C., Elliott, H., Hay, S. I., Lidral-Porter, B., Nam, S., Shyong, C., Tsakalos, G., Zlavog, B. S., Barış, E., Murray, C. J. L., & Dieleman, J. L. (2025). Tracking development assistance for health, 1990–2030: Historical trends, recent cuts, and outlook. The Lancet, S0140673625012401. https://doi.org/10.1016/S0140-6736(25)01240-1
