Diabetes Self-Management Blog

The health benefits of exercise, such as helping control blood glucose and maintain weight loss, are well known. But new evidence published in the journal BMJ indicates that physical activity may be as effective as drugs at reducing the risk of death in people with stroke, heart disease, and prediabetes.

Much research has been done to evaluate the effectiveness of medicines in treating health conditions, but to date, few studies have been conducted to determine the relative effectiveness of physical activity for treating those conditions. To address this gap in knowledge, researchers analyzed results from 54 exercise intervention trials and 248 drug intervention trials, the results of which were used to compare the effectiveness of the two types of interventions in people with coronary heart disease, stroke, prediabetes, and heart failure.

The comparison found no statistically detectable differences between physical activity and drugs for reducing mortality in people with heart disease or prediabetes. In people who had had a stroke, exercise was shown to be more effective than medicine, while drugs worked better for those dealing with heart failure.

“Exercise and many drug interventions are often potentially similar in terms of their mortality benefits; exercise interventions should therefore be considered as a viable alternative to, or alongside, drug therapy,” the researchers suggest.

One limitation of the trial was that all the physical activity interventions were considered together despite differences in type, duration, and intensity. A further limitation was the potential for unobserved variables, such as differing patient populations across the studies, affecting the results. The study authors have called for further trials.

Despite the limitations, the research “highlights the near absence of evidence on the comparative effectiveness of exercise and drug interventions on mortality outcomes,” the researchers note. “This blind spot in available scientific evidence prevents prescribers and their patients from understanding the clinical circumstances where drugs might provide only modest improvement but exercise could yield more profound or sustainable gains in health.”

For more information, read the article “Exercise May Equal Drugs for CVD Survival” or see the study in journal BMJ. And for ideas on making exercise more fun, read this piece by exercise physiologist and certified diabetes educator Richard M. Weil.


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