Walking and all-cause, coronary heart disease, and cardiovascular disease mortality in older adults with and without diabetes

Purpose Type 2 diabetes has a 3- to 5-fold excess risk of cardiovascular death. This prospective study examines the association of walking with mortality in persons with type 2 diabetes (n = 347) and normal glucose tolerance (n = 1327). Methods Participants were community-dwelling adults from the Rancho Bernardo Study aged 50–90 in 1984–1986. Walking at baseline was ascertained by questionnaire. Nosologist coded death certificates were 97.9% complete for all deaths. Multivariable Cox proportional hazard regression modeling was used to model time until death. Results Cox models adjusting for sex, age, smoking, body mass index, alcohol, exercise, CHD history, and other covariates, showed that adults with diabetes who walked ≥1 mile per day were half as likely to die from all-causes combined (HR = 0.55; 95% CI = 0.34–0.90), and less than one fifth as likely to die from non-CHD CVD causes (HR = 0.19; 95% CI = 0.04–0.86) compared to adults with diabetes who did not walk. Walking was also protective among adults with normal glucose tolerance, but with a smaller effect size. Conclusion Results suggest walking ≥1 mile per day may provide stronger protection from all-cause and non-CHD CVD mortality in older adults with diabetes than those with normal glucose tolerance.