Even limited weekly exercise can significantly reduce the risk of heart-related death in people with diabetes, according to a major new study involving over 50,000 adults. The findings challenge the belief that physical activity must be spread throughout the week to offer health benefits.
The Study
Researchers from Harvard, Boston University, Vanderbilt, and Capital Medical University in Beijing analyzed data from 51,650 adults with diabetes, collected through the U.S. National Health Interview Survey (NHIS) from 1997 to 2018. Participants were divided into four categories: those who did not exercise at all, those who exercised less than the recommended 150 minutes per week, those who met or exceeded this threshold in just one or two sessions, and those who spread it across at least three days per week.
The study categorized participants into four distinct exercise patterns based on how often and how much they exercised each week. The first group included individuals who were completely inactive and did not engage in any form of physical activity. The second group consisted of those who were insufficiently active, meaning they exercised but for less than the recommended 150 minutes per week. The third group involved participants who did meet or even exceed the 150-minute weekly threshold, but did so in just one or two sessions—often on weekends—rather than spreading it out. Finally, the fourth group comprised individuals who followed a consistent exercise routine, distributing at least 150 minutes of moderate to vigorous physical activity across three or more sessions throughout the week.
The results were striking. Diabetic individuals who exercised for at least 150 minutes a week—regardless of whether it was over two sessions or several—experienced a 21% lower risk of death from all causes and a 33% lower risk of cardiovascular-related death compared to those who did not exercise. Those who exercised three or more times weekly had a 17% lower all-cause mortality risk and 19% lower cardiovascular mortality.
The study, published in the Annals of Internal Medicine, highlights that what matters most is meeting the weekly activity duration—not how the time is distributed. Moderate to vigorous exercise, even if performed only on weekends, can serve as a powerful tool for heart health and longevity in people living with diabetes. However, the study found no significant reduction in cancer-related mortality across the different exercise groups.