Exercise prevents death in diabetes patients with MI

Regularly engaging in any physical activity (PA) can help reduce the risk of death in patients with diabetes and myocardial infarction (MI), suggests a study presented at ADA 2025. 

Using data from the 2001 to 2014 annual National Health Interview Survey, researchers led by Dr Issa Zahrieh from New York University, New York, US, identified patients with diabetes and MI. They then categorized the levels of PA among participants as inactive, insufficiently active, sufficiently active, and highly active following the CDC adult exercise guidelines. 

Zahrieh and her team obtained data on mortality and follow-up time from the National Death Index-linked mortality files and computed the mortality rates using life table methods. They examined the independent effect of PA categories on mortality using multivariate Cox proportional hazards models adjusted for age, sex, race, obesity, education, diet, smoking status, alcohol use, and marital status. 

A total of 421,106 US adults participated in the surveys from 2001 to 2014, of whom 4,698 had diabetes and MI. Among individuals with diabetes and MI, 1,631 died over the follow-up period. [ADA 2025, abstract 120-OR] 

Based on the exercise category, the mortality rates were 89 per 1,000 person-years (PY) among inactive participants, 62 per 1,000 PY among insufficiently active individuals, 50 per 1,000 PY among sufficiently active adults, and 44 per 1,000 PY in the highly active cohort. 

In multivariate analysis, the highly active cohort showed the lowest risk of mortality (hazard ratio [HR], 0.49, 95 percent confidence interval [CI], 0.39–0.60), followed by participants with sufficient activity (HR, 0.57, 95 percent CI, 0.46–0.70) and those with insufficient activity (HR, 0.75, 95 percent CI, 0.64–0.89), compared with inactive participants. 

“In this population-based analysis, [diabetes patients with MI] who regularly exercised were at a lower risk of death compared to those who were inactive, with the highest physical activity levels showing the most benefit,” said Zahrieh.  

“Further research is needed to elucidate the mechanisms for the benefit among patients with [diabetes and MI],” she added. 

Survival benefit 

These findings are consistent with those of a study involving Korean adults aged ≥20 years with new-onset type 2 diabetes. 

Based on the results of this study, patients with new-onset diabetes who engaged in moderate-to-vigorous PA (MVPA) had a significantly reduced risk of death when compared with sedentary individuals without diabetes. [ADA 2025, abstract 119-OR] 

Specifically, adults with new-onset diabetes and MVPA had a 33-percent lower risk of all-cause mortality (HR, 0.67, 95 percent CI, 0.61–0.73), while those with no diabetes who engaged in MVPA had a 49-percent reduced risk (HR, 0.51, 95 percent CI, 0.548–0.55), compared with participants with no diabetes and no MVPA. 

In addition, the highest risk of death was observed among patients with new-onset diabetes and no MVPA (HR, 1.44, 95 percent CI, 1.37–1.51).