Online first
Research paper
Published online: 2024-11-21

open access

Page views 18
Article views/downloads 3
Get Citation

Connect on Social Media

Connect on Social Media

Effect of Single, Accumulated, and Conventional Walking on Glucose Level, Aerobic Capacity, Fatigue, and Quality of Life in Type 2 Diabetes: A Randomized Trial

Shreya G. Mendon1, Suroshree Mitra1, Apurv P. Shimpi1

Abstract

Objective: This study evaluated the effectiveness of different walking protocols on various physiological and psychological factors in type 2 diabetes (T2D). Materials and methods: In this randomized study, 45 individuals with T2D, aged 55–65 years, with diabetes duration between 1 and 10 years were recruited. They were randomly assigned to 1 of 3 groups: single walking (SW), accumulated walking (AW), or conventional walking (CW). The primary outcome measure was fasting blood glucose (FBG) while secondary outcomes assessed were 6-minute walk distance (6MWD), fatigue, and quality of life (QoL). Intervention was given for 6 weeks. Intra-group changes were analyzed using the Wilcoxon signed rank test, while inter-group differences were evaluated with the Kruskal-Wallis test. Results: 42 participants completed the study. The baseline data showed non-significant difference across the groups for age and duration of diabetes. FBG showed a minor reduction in the SW (12%) and AW (15.5%) groups, while it increased in the CW group (2.5%). The 6MWD improved significantly in the SW (21.3%, p = 0.003) and AW (21%, p = 0.008) groups, but decreased in the CW (9.5%) group. Fatigue decreased in the SW (4.5%, p = 0.027) and AW (4.8%, p = 0.003) groups, while it slightly increased in the CW (0.5%) group. QoL improved in the SW (2.3%, p = 0.016) and AW (4.3%, p = 0.008) groups but decreased in the CW (1.78%) group. Post-hoc analysis showed significant differences in 6MWD (p = 0.010) and QoL (p = 0.008) between the AW and CW groups. Conclusions: SW and AW showed similar effects on glucose levels, aerobic capacity, fatigue, and QoL. However, AW is more effective than CW in enhancing aerobic capacity and QoL.

Article available in PDF format

View PDF Download PDF file

References

  1. Goyal R. Type 2 diabetes. U.S. National Library of Medicine; 2023. https://www.ncbi.nlm.nih.gov/books/NBK513253/ (22.04.2024).
  2. ElSayed NA, Aleppo G, Aroda VR, et al. 2. Classification and Diagnosis of Diabetes: Standards of Care in Diabetes-2023. Diabetes Care. 2023; 46(Suppl 1): S19–S40.
  3. Pradeepa R, Mohan V, et al. Epidemiology of type 2 diabetes in India. Indian J Ophthalmol. 2021; 69(11): 2932–2938.
  4. Poitras VJ, Hudson RW, Tschakovsky ME. Exercise intolerance in Type 2 diabetes: is there a cardiovascular contribution? J Appl Physiol (1985). 2018; 124(5): 1117–1139.
  5. Bin Rakhis SA, AlDuwayhis NM, Aleid N, et al. Glycemic Control for Type 2 Diabetes Mellitus Patients: A Systematic Review. Cureus. 2022; 14(6): e26180.
  6. Alghadir A, Gabr S, Anwer S, et al. Fatigue and oxidative stress response to physical activity in type 2 diabetic patients. International Journal of Diabetes in Developing Countries. 2015; 36(1): 59–64.
  7. Ba J, Chen Y, Liu D. Fatigue in Adults with Type 2 Diabetes: A Systematic Review and Meta-analysis. West J Nurs Res. 2021; 43(2): 172–181.
  8. Drivsholm T, de Fine Olivarius N, Nielsen ABS, et al. Symptoms, signs and complications in newly diagnosed type 2 diabetic patients, and their relationship to glycaemia, blood pressure and weight. Diabetologia. 2005; 48(2): 210–214.
  9. Guglani R, Shenoy S, Sandhu JS. Effect of progressive pedometer based walking intervention on quality of life and general well being among patients with type 2 diabetes. J Diabetes Metab Disord. 2014; 13(1): 110.
  10. Fayehun AF, Olowookere OO, Ogunbode AM, et al. Walking prescription of 10 000 steps per day in patients with type 2 diabetes mellitus: a randomised trial in Nigerian general practice. Br J Gen Pract. 2018; 68(667): e139–e145.
  11. Belli T, Ribeiro LF, Ackermann MA, et al. Effects of 12-week overground walking training at ventilatory threshold velocity in type 2 diabetic women. Diabetes Res Clin Pract. 2011; 93(3): 337–343.
  12. Schachter CL, Busch AJ, Peloso PM, et al. Effects of short versus long bouts of aerobic exercise in sedentary women with fibromyalgia: a randomized controlled trial. Phys Ther. 2003; 83(4): 340–358.
  13. Kanaley JA, Colberg SR, Corcoran MH, et al. Exercise/Physical Activity in Individuals with Type 2 Diabetes: A Consensus Statement from the American College of Sports Medicine. Med Sci Sports Exerc. 2022; 54(2): 353–368.
  14. Kermani SK, Khatony A, Jalali R, et al. Accuracy and Precision of Measured Blood Sugar Values by Three Glucometers Compared to the Standard Technique. J Clin Diagn Res. 2017; 11(4): OC05–OC08.
  15. ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002; 166(1): 111–117.
  16. Smets EM, Garssen B, Bonke B, et al. The Multidimensional Fatigue Inventory (MFI) psychometric qualities of an instrument to assess fatigue. J Psychosom Res. 1995; 39(3): 315–325.
  17. Carey MP, Jorgensen RS, Weinstock RS, et al. Reliability and validity of the appraisal of diabetes scale. J Behav Med. 1991; 14(1): 43–51.
  18. Centers for Disease Control and Prevention | CDC [Internet]. Measuring Physical Activity Intensity | Physical Activity; 2020. https://www.cdc.gov/physicalactivity/basics/measuring/index.html (26.04.2022).
  19. Abd El-Kader SM, Al-Jiffri OH, Al-Shreef FM. Aerobic exercises alleviate symptoms of fatigue related to inflammatory cytokines in obese patients with type 2 diabetes. Afr Health Sci. 2015; 15(4): 1142–1148.
  20. Eriksen L, Dahl-Petersen I, Haugaard SB, et al. Comparison of the effect of multiple short-duration with single long-duration exercise sessions on glucose homeostasis in type 2 diabetes mellitus. Diabetologia. 2007; 50(11): 2245–2253.
  21. Reynolds AN, Mann JI, Williams S, et al. Advice to walk after meals is more effective for lowering postprandial glycaemia in type 2 diabetes mellitus than advice that does not specify timing: a randomised crossover study. Diabetologia. 2016; 59(12): 2572–2578.
  22. Pahra D, Sharma N, Ghai S, et al. Impact of post-meal and one-time daily exercise in patient with type 2 diabetes mellitus: a randomized crossover study. Diabetol Metab Syndr. 2017; 9: 64.
  23. Zhang X, Zheng C, Ho RST, et al. The Effects of Accumulated Versus Continuous Exercise on Postprandial Glycemia, Insulin, and Triglycerides in Adults with or Without Diabetes: A Systematic Review and Meta-Analysis. Sports Med Open. 2022; 8(1): 14.
  24. Shambrook P, Kingsley MI, Taylor NF, et al. Accumulated or continuous exercise for glycaemic regulation and control: a systematic review with meta-analysis. BMJ Open Sport Exerc Med. 2018; 4(1): e000470–907.
  25. Kenney WL, Wilmore JH, Costill DL. Physiology of sport and exercise. 8th ed. Human Kinetics, Champaign, IL 2021.
  26. Singh R, Teel C, Sabus C, et al. Fatigue in Type 2 Diabetes: Impact on Quality of Life and Predictors. PLoS One. 2016; 11(11): e0165652.
  27. Kalra S, Sahay R. Diabetes Fatigue Syndrome. Diabetes Ther. 2018; 9(4): 1421–1429.
  28. Bi Y, Zhang Lu, Li X, et al. Contributing factors of fatigue in patients with type 2 diabetes: A systematic review. Psychoneuroendocrinology. 2021; 130: 105280.
  29. Park H, Park C, Quinn L, et al. Glucose control and fatigue in type 2 diabetes: the mediating roles of diabetes symptoms and distress. J Adv Nurs. 2015; 71(7): 1650–1660.
  30. Aarthy R, Mikocka-Walus A, Pradeepa R, et al. Quality of Life and Diabetes in India: A Scoping Review. Indian J Endocrinol Metab. 2021; 25(5): 365–380.
  31. Cai H, Li G, Zhang P, et al. Effect of exercise on the quality of life in type 2 diabetes mellitus: a systematic review. Qual Life Res. 2017; 26(3): 515–530.
  32. Esha K, Prajakta S, Ashok S, et al. Effect of alternate walking and yoga on blood sugar levels in type 2 diabetes. Indian Journal of Physiology and Pharmacology. 2019; 63(1): 16–20.
  33. Praet SFE, van Rooij ESJ, Wijtvliet A, et al. Brisk walking compared with an individualised medical fitness programme for patients with type 2 diabetes: a randomised controlled trial. Diabetologia. 2008; 51(5): 736–746.
  34. Aylin K, Arzu D, Sabri S, et al. The effect of combined resistance and home-based walking exercise in type 2 diabetes patients. Int J Diabetes Dev Ctries. 2009; 29(4): 159–165.
  35. Morton RD, West DJ, Stephens JW, et al. Heart rate prescribed walking training improves cardiorespiratory fitness but not glycaemic control in people with type 2 diabetes. J Sports Sci. 2010; 28(1): 93–99.