The Benefits of Cycling for Individuals With Diabetes

Timothy S. Harlan, MD, FACP, CCMS

Your patient is a 55-year-old man with type 2 diabetes who is worried about his health as he ages. He asks you if there are any recommended forms of exercise that can help him feel better about his health

HOW DO YOU ADVISE YOUR PATIENT?

(Answer and discussion as under)

Discussion

A study that suggests that exercise can help reduce the risk of developing diabetes1 in those who are overweight or obese. In fact, "for every additional 17 minutes of brisk daily walking, the participants saw a 6% reduction in their risk of developing diabetes." Yet exercise is also important for those who already have diabetes; it helps improve glucose control and cardiovascular fitness and reduces the risk of overall mortality as well as mortality due to heart disease.2

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The Benefits of Cycling for Individuals With Diabetes

An international team of researchers noted that one of the greatest barriers to regular exercise is time.3 What if people with diabetes started using a bicycle for regular short-to-medium trips, such as commuting? What impact might that have on their risk of mortality?

The Research. The European Prospective Investigation into Cancer and Nutrition (EPIC) is an ongoing study that began recruiting participants in 10 Western European countries. Over 500,000 men and women are included, but for today’s research, the authors focused on the over 7400 people who had been diagnosed with diabetes (any type) before the study began.

Upon recruitment, the participants responded to a detailed lifestyle survey that allowed the researchers to assess the participants' levels and types of physical activity, from the nature of their work to any leisure time exercise as well as activities of daily life.

Additionally, the participants completed a detailed dietary questionnaire as well as demographic and medical history surveys. Their height, weight, and waist circumference were recorded along with their medical history. Five years later, the surviving participants again responded to a lifestyle questionnaire.

After an average of 10 years of follow-up, the authors compared the amount of cycling the surviving participants reported at the start of the study with that of those participants who passed away.

The Results. After considering several variables—from

WHAT’S THE “TAKE HOME”?

Mediterranean diet score to other health conditions such as high blood pressure—the authors found that compared to those who did not bicycle at the start of the study, those who averaged less than one hour of cycling per week were 22% less likely to die of any cause. Those who cycled between 60 and 149 minutes per week reduced their risk of death by 24%, and those who bicycled between 150 and 299 minutes per week were 32% less likely to die of any cause.

With the results from the follow-up survey, the authors could also look at those who started cycling after the initial survey, those who stopped cycling, and those who reported cycling at both surveys.

Individuals who maintained their cycling habit enjoyed the lowest risk of mortality from heart disease or any other cause—a drop of about 36%. But those who did not initially bicycle but reported any amount of cycling at the second survey still saw their overall risk of death fall by 34%. Similar results held for risk of death from heart disease.

REFERENCE:

1. Harlan TS. Exercise more effective than medication in preventing diabetes. Dr. Gourmet. Published April 14, 2021. Accessed January 3, 2023. https://www.drgourmet.com/bites/2021/041421.shtml

2. Colberg SR, Sigal RJ, Yardley JE, et al. Physical activity/exercise and diabetes: a position statement of the American Diabetes Association. Diabetes Care. 2016;39(11):2065-2079. doi:10.2337/dc16-1728

3. Ried-Larsen, M, Rasmussen MG, Blond K, et al. Association of cycling with all-cause and cardiovascular disease mortality among persons with diabetes. JAMA Intern Med. 2021;181(9):1196-1205. doi:10.1001/jamainternmed.2021.3836