Lifestyle changes after the diagnosis of new-onset type 2 diabetes plays a pivotal role in reducing the CVD and mortality risk. A recent study published in ‘Scientific reports’ explored the effects of changes in smoking and exercise on the risk of cardiovascular disease (CVD) and mortality in patients with newly diagnosed diabetes. Data were analyzed for 181,591 people with newly diagnosed type 2 diabetes who underwent 2 serial health examinations within 2 years before and after diabetes diagnosis. The study population was followed from the baseline to the date of death or cardiovascular events. On the basis of change in status from before to after the diagnosis, participants were grouped into smoking groups (continuous smokers, quitters, new smokers, and nonsmokers) and exercise groups (constant exercisers, new exercisers, exercise dropouts, and non exercisers).

Compared with the non exercisers, those who initiated exercise after their diabetes diagnosis had a lower risk of myocardial infarction (MI), stroke, and all-cause mortality: the hazard ratio (HR; 95% confidence interval [CI]) was 0.85 (0.76–0.94) for MI, 0.86 (0.78–0.94) for stroke, and 0.84 (0.89–0.90) for all-cause mortality. Quitters had a higher risk of MI, stroke, and all-cause mortality than nonsmokers, but their risk level was much lower than that in continuous smokers. When the group of continuous smokers and non exercisers was considered as the reference group, participants who quit smoking and remained non exercisers had a 21% lower risk of CVD. Those who quit smoking and started exercising had a 46% reduced risk of CVD (HR 0.54; 95% CI 0.41–0.71) and a 22% reduced risk in all-cause mortality (HR 0.78; 95% CI 0.63–0.96).