Walking with Diabetes (WW-DIAB) programme a walking programme for Indonesian type 2 diabetes mellitus patients: A pilot randomised controlled trial
Open accessAbstract
OBJECTIVES: This pilot study aimed to examine the feasibility and effectiveness of a pedometer-based walking programme in Indonesian type 2 diabetes mellitus patients. METHODS: Feasibility was assessed by monitoring participant recruitment, retention, and adherence to the step-monitoring and recording instructions. Effectiveness was assessed in a pilot randomised controlled trial. Participants were type 2 diabetes mellitus patients randomly assigned to a pedometer-only (PED-only) group (n = 22) and a pedometer with text message support (PED+) group (n = 21). Outcomes were step counts, self-reported physical activity, social cognitive constructs, glycaemic parameters, and health-related quality of life. These were assessed at baseline, 12-week intervention, and 12 weeks later. Longitudinal analyses using generalised estimating equations were carried out to assess treatment and time effects on study outcomes. RESULTS: All but one participant (98%) attended 12- and 24-week data collection follow-ups. Throughout the study period, 82% of PED+ participants submitted their daily steps log. Daily steps increased in both groups (p < 0.001) but more in the PED+ group (2064 more steps at week 24, 95% confidence interval: 200-3925, p = 0.03). Self-reported physical activity levels and glycaemic parameters increased similarly in the two groups over time (p < 0.05). Improvements in social cognitive processes were seen only in the PED+ group (p < 0.05). There were no significant improvements in health-related quality of life. CONCLUSION: This study provides preliminary evidence that a pedometer-based walking programme, with or without additional support, is feasible and improves physical activity and glucose levels in Indonesian type 2 diabetes mellitus patients. Greater increases in step counts can result from the provision of text message support and education materials than from the provision of a pedometer only.
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Increased daily activity may contribute to better metabolic control.
“suggesting that increased daily activity may contribute to better metabolic control [13,23].”
A subset of interventions explicitly reported a net increase in daily steps or minutes of activity following the intervention.
“A subset of interventions explicitly reported a net increase in daily steps or minutes of activity following the intervention [13,23], offering a clear estimate of behavioural change over time.”
Some studies reported reductions in HbA1c, fasting glucose, or 2 h post-load glucose over time, even in the absence of statistically significant group-by-time interactions.
“Some studies reported reductions in HbA1c, fasting glucose, or 2 h post-load glucose over time, even in the absence of statistically significant group-by-time interactions”
No meaningful changes in BMI or other anthropometric indicators were observed in most trials.
“No meaningful changes in BMI or other anthropometric indicators were observed in most trials [13,14,23,33].”
Most interventions did not produce significant changes in systolic or diastolic values, particularly when baseline blood pressure was already within the normal range.
“Most interventions did not produce significant changes in systolic or diastolic values, particularly when baseline blood pressure was already within the normal range [23,26].”
The effectiveness of wearable devices appears to depend largely on how they are integrated into the overall intervention, particularly in relation to the level of structure, the consistency and nature of behavioural support, and the presence of clearly defined, measurable objectives.
“Their effectiveness appears to depend largely on how they are integrated into the overall intervention, particularly in relation to the level of structure, the consistency and nature of behavioural support, and the presence of clearly defined, measurable objectives [17,20,21,22,23,26,28].”
In unstructured or passively monitored cases, wearable devices functioned primarily as tools for awareness and data collection, rather than as drivers of behavioural change.
“In such cases, wearable devices functioned primarily as tools for awareness and data collection, rather than as drivers of behavioural change [9,13,23,26,33].”
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- Authors
- Arovah, N. I., Kushartanti, B. M. W., Washington, T. L., & Heesch, K. C.
- Affiliations
- Yogyakarta State University (ID)
- Queensland University of Technology (AU)
- Corresponding author
- Arovah, Novita Intan
- Venue
- SAGE Open Medicine
- Publisher
- SAGE Publications
- Published
- 2018-01
- Volume
- 6
- Pages
- 2050312118814391-2050312118814391
- ISSN
- 2050-3121 (ISSN-L)
- PMC
- PMC8826095
- OpenAlex
- W2901217767
- Cited by
- 14
- References
- 30
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 1 · 2023: 3 · 2022: 1 · 2021: 1 · 2019: 1
- FWCI
- 0.34
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- SAGE Open Medicine (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- QUT ePrints (Queensland University of Technology) (submittedVersion, cc-by-nc)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- University Unggulan Grant from the Indonesian Research and Higher Education Ministry (25|UPT/UN34.21/2016)
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- type 2 diabetes, walking program, pedometers, text message support, physical activity, step count, glycemic control, socio-cognitive processes, health-related quality of life, feasibility, Indonesian patients
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