Researchers have warned that a significant share of serious heart and vascular complications in Indians living with diabetes can be traced to low levels of movement and exercise.
Key findings from the global study
- Over 13 per cent of heart failure cases among people with diabetes in India could be attributed to physical inactivity.
- The study also estimated that 9.6 per cent of coronary heart disease and 9.4 per cent of cardiovascular complications in this group were linked to a lack of physical activity.
- Globally, one in ten cases of macrovascular complications and diabetic retinopathy in people with diabetes was associated with physical inactivity.
The analysis, published in the Journal of Sport and Health Science, pooled data from more than 2.3 million adults with diabetes across different world regions, including South Asia.
Activity can prevent “inevitable” complications
Lead author Jayne Feter, a researcher at the School of Medicine at Brazil’s Universidade Federal do Rio Grande do Sul, said that complications are often regarded as an unavoidable part of diabetes, but the new estimates challenge that view.
“Diabetes complications are often seen as inevitable consequences of the disease. Our findings challenge this idea by showing that a meaningful proportion of these complications could be prevented through achievable increases in physical activity among people living with diabetes,” Feter said.
The World Health Organization recommends at least 150 minutes per week of moderate to vigorous physical activity for adults. The study team combined data from population-based cohort studies and national surveys with risk estimates drawn from large international meta-analyses and global physical activity surveillance systems.
India’s large diabetes burden
India is estimated to be home to more than one-fourth of the world’s diabetes population, according to a 2024 study in The Lancet, which means even modest risk reductions could translate into a large number of prevented complications.
Physical inactivity in people with diabetes was found to account for more than 10 per cent of strokes, 9.7 per cent of diabetic retinopathy, 7.3 per cent of heart failure and around 5 to 7 per cent of cardiovascular and coronary heart disease cases.
Complications arise over time as high blood sugar damages blood vessels and nerves throughout the body, and treating these problems is taking up a growing share of health budgets, particularly in health systems that are already under strain.
Inequities by gender and education
The researchers reported that women and people with lower education levels consistently experienced a higher proportion of complications attributable to physical inactivity.
They said these patterns point to deep social inequities and underline the need for public health strategies that are sensitive to gender and socioeconomic barriers to regular exercise.
Call to embed activity in diabetes care
The authors argue that promoting regular movement should be at the heart of diabetes management and national non-communicable disease plans.
“This study reframes physical activity as a core component of diabetes complication prevention. Promoting physical activity among people with diabetes could reduce hospitalisations, disability, and healthcare costs, while improving quality of life,” Jayne Feter said.
Co-author Natan Feter, from the Department of Biological Sciences at the University of Southern California, stressed that action can no longer be delayed.
“Integrating physical activity promotion into routine diabetes care and national noncommunicable disease strategies is no longer optional. Policies must be tailored to local realities and explicitly address social and gender inequalities,” he said.
