Evidence summary (Updated 2022)
Observational studies have shown that regular exercise is associated with improved fitness and lower risk of all-cause and CV mortality [1-4]
From a recent longitudinal study spanning over 27 years it has highlighted that a higher mortality rate is recognized amongst T2DM patients and that exercise has been regularly reported to reduce the mortality risk in people with or without T2DM as a whole. Multiple studies have shown moderate to vigorous physical activity of any duration is an important intervention to prevent risk of type 2 diabetes and reduce mortality secondary to T2DM (2-4). Recommended durations required for lowering risk of CVD mortality by the WHO and UK CMOs guidance 2019 are greater or equal to 150 minutes per week of moderate-to-vigorous physical activity or greater or equal to 75 minutes per week of vigorous physical activity. [5-7]
Quality of Evidence
A – High Quality
Strength of recommendation
Grade 1 – Strong recommendation
Regular moderate to vigorous exercise of any duration has reported reduced mortality risk in people with T2DM.
 Boulé NG, Kenny GP, Haddad E, Wells GA, Sigal RJ. Meta-analysis of the effect of structured exercise training on cardiorespiratory fitness in Type 2 diabetes mellitus. Diabetologia. 2003 Aug;46(8):1071-81.
 Chudyk A, Petrella RJ. Effects of exercise on cardiovascular risk factors in type 2 diabetes: a meta-analysis Diabetes Care. 2011 May;34(5):1228-37.
 Gregg EW, Gerzoff RB, Caspersen CJ, Williamson DF, Narayan KM. Relationship of walking to mortality among US adults with diabetes. Arch Intern Med. 2003 Jun 23;163(12):1440-7.
 Sluik D, Buijsse B, Muckelbauer R, Kaaks R, Teucher B, Johnsen NF, Tjønneland A, Overvad K, Ostergaard JN, Amiano P, Ardanaz E, Bendinelli B, Pala V, Tumino R, Ricceri F, Mattiello A, Spijkerman AM, Monninkhof EM, May AM, Franks PW, Nilsson PM, Wennberg P, Rolandsson O, Fagherazzi G, Boutron-Ruault MC, Clavel-Chapelon F, Castaño JM, Gallo V, Boeing H, Nöthlings U. Physical Activity and Mortality in Individuals With Diabetes Mellitus: A Prospective Study and Meta-analysis. Arch Intern Med. 2012 Sep 24;172(17):1285-95.
 Yerramalla M. et al Association of moderate and vigorous physical activity with incidence of type 2 diabetes and subsequent mortality: 27 year follow-up of the Whitehall II study Diabetologia (2020) 63:537–548 https://link.springer.com/article/10.1007%2Fs00125-019-05050-1
 World Health Organization. (2020). WHO guidelines on physical activity and sedentary behaviour. World Health Organization. https://apps.who.int/iris/handle/10665/336656. License: CC BY-NC-SA 3.0 IGO
 UK Chief Medical Officers’ Physical Activity Guidelines. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/832868/uk-chief-medical-officers-physical-activity-guidelines.pdf Published 7 September 2019