Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2013 Feb;36(2):228-36.
doi: 10.2337/dc12-0658. Epub 2012 Sep 21.

The Effects of Free-Living Interval-Walking Training on Glycemic Control, Body Composition, and Physical Fitness in Type 2 Diabetic Patients: A Randomized, Controlled Trial

Affiliations
Free PMC article
Randomized Controlled Trial

The Effects of Free-Living Interval-Walking Training on Glycemic Control, Body Composition, and Physical Fitness in Type 2 Diabetic Patients: A Randomized, Controlled Trial

Kristian Karstoft et al. Diabetes Care. .
Free PMC article

Abstract

Objective: To evaluate the feasibility of free-living walking training in type 2 diabetic patients and to investigate the effects of interval-walking training versus continuous-walking training upon physical fitness, body composition, and glycemic control.

Research design and methods: Subjects with type 2 diabetes were randomized to a control (n = 8), continuous-walking (n = 12), or interval-walking group (n = 12). Training groups were prescribed five sessions per week (60 min/session) and were controlled with an accelerometer and a heart-rate monitor. Continuous walkers performed all training at moderate intensity, whereas interval walkers alternated 3-min repetitions at low and high intensity. Before and after the 4-month intervention, the following variables were measured: VO(2)max, body composition, and glycemic control (fasting glucose, HbA(1c), oral glucose tolerance test, and continuous glucose monitoring [CGM]).

Results: Training adherence was high (89 ± 4%), and training energy expenditure and mean intensity were comparable. VO(2)max increased 16.1 ± 3.7% in the interval-walking group (P < 0.05), whereas no changes were observed in the continuous-walking or control group. Body mass and adiposity (fat mass and visceral fat) decreased in the interval-walking group only (P < 0.05). Glycemic control (elevated mean CGM glucose levels and increased fasting insulin) worsened in the control group (P < 0.05), whereas mean (P = 0.05) and maximum (P < 0.05) CGM glucose levels decreased in the interval-walking group. The continuous walkers showed no changes in glycemic control.

Conclusions: Free-living walking training is feasible in type 2 diabetic patients. Continuous walking offsets the deterioration in glycemia seen in the control group, and interval walking is superior to energy expenditure-matched continuous walking for improving physical fitness, body composition, and glycemic control.

Trial registration: ClinicalTrials.gov NCT01234155.

Figures

Figure 1
Figure 1
Subjects with type 2 diabetes were randomized to a CON (white bars), CWT (striated bars), or IWT group (black bars). Aerobic fitness (VO2max) (A), body mass (B), whole-body fat mass (dual-energy X-ray absorptiometry) (C), and abdominal visceral adiposity (MRI) (D) were measured at baseline and after 4 months. Data are presented as mean Δ values (post − preintervention values) ± SEM. Statistical differences were analyzed by two-way repeated-measures ANOVA when comparing pre to post changes within groups (indicated by ***P < 0.001), and one-way ANOVA of Δ values when comparing differences between groups (indicated by a connecting line between bars; *P < 0.05 and **P < 0.01).
Figure 2
Figure 2
Subjects with type 2 diabetes were randomized to a CON (white bars), CWT (striated bars), or IWT group (black bars). Intervention-induced changes in glycemic control were assessed by examining post − preintervention changes in the following variables: mean 48-h CGM glucose (A), minimum 48-h CGM glucose (B), and maximum 48-h CGM glucose (C). Data are presented as mean Δ values (post − preintervention values) ± SEM. Statistical differences were analyzed by two-way repeated-measures ANOVA when comparing pre to post changes within groups (indicated by *P < 0.05 and **P < 0.01), and one-way ANOVA of Δ values when comparing differences between groups (indicated by a connecting line between bars; **P < 0.01).

Similar articles

See all similar articles

Cited by 75 articles

See all "Cited by" articles

References

    1. Shaw JE, Sicree RA, Zimmet PZ. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract 2010;87:4–14 - PubMed
    1. Snowling NJ, Hopkins WG. Effects of different modes of exercise training on glucose control and risk factors for complications in type 2 diabetic patients: a meta-analysis. Diabetes Care 2006;29:2518–2527 - PubMed
    1. Boulé NG, Haddad E, Kenny GP, Wells GA, Sigal RJ. Effects of exercise on glycemic control and body mass in type 2 diabetes mellitus: a meta-analysis of controlled clinical trials. JAMA 2001;286:1218–1227 - PubMed
    1. Myers J, Prakash M, Froelicher V, Do D, Partington S, Atwood JE. Exercise capacity and mortality among men referred for exercise testing. N Engl J Med 2002;346:793–801 - PubMed
    1. Wei M, Gibbons LW, Kampert JB, Nichaman MZ, Blair SN. Low cardiorespiratory fitness and physical inactivity as predictors of mortality in men with type 2 diabetes. Ann Intern Med 2000;132:605–611 - PubMed

Publication types

Associated data

Feedback