Impact of Walking on Glycemic Control and Other Cardiovascular Risk Factors in Type 2 Diabetes: A Meta-Analysis
Open accessAbstract
BACKGROUND: Walking is the most popular and most preferred exercise among type 2 diabetes patients, yet compelling evidence regarding its beneficial effects on cardiovascular risk factors is still lacking. The aim of this meta-analysis of randomized controlled trials (RCTs) was to evaluate the association between walking and glycemic control and other cardiovascular risk factors in type 2 diabetes patients. METHODS: Three databases were searched up to August 2014. English-language RCTs were eligible for inclusion if they had assessed the walking effects (duration ≥8 weeks) on glycemic control or other cardiovascular risk factors among type 2 diabetes patients. Data were pooled using a random-effects model. Subgroup analyses based on supervision status and meta-regression analyses of variables regarding characteristics of participants and walking were performed to investigate their association with glycemic control. RESULTS: Eighteen studies involving 20 RCTs (866 participants) were included. Walking significantly decreased glycosylated haemoglobin A1c (HbA1c) by 0.50% (95% confidence intervals [CI]: -0.78% to -0.21%). Supervised walking was associated with a pronounced decrease in HbA1c (WMD -0.58%, 95% CI: -0.93% to -0.23%), whereas non-supervised walking was not. Further subgroup analysis suggested non-supervised walking using motivational strategies is also effective in decreasing HbA1c (WMD -0.53%, 95% CI: -1.05% to -0.02%). Effects of covariates on HbA1c change were generally unclear. For other cardiovascular risk factors, walking significantly reduced body mass index (BMI) and lowered diastolic blood pressure (DBP), but non-significantly lowered systolic blood pressure (SBP), or changed high-density or low-density lipoprotein cholesterol levels. CONCLUSIONS: This meta-analysis supports that walking decreases HbA1c among type 2 diabetes patients. Supervision or the use of motivational strategies should be suggested when prescribed walking to ensure optimal glycemic control. Walking also reduces BMI and lowers DBP, however, it remains insufficient regarding the association of walking with lowered SBP or improved lipoprotein profiles. TRIAL REGISTRATION: PROSPERO CRD42014009515.
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Low-intensity physical activities such as walking, yoga, tai-chi, qigong, and household tasks reduce hyperglycemia in type 2 diabetes.
“low-intensity PA such as walking, yoga, tai-chi, qigong, and activity for household tasks have also been shown to be effective methods of reducing hyperglycemia.”
From The Impact of Physical Activity in Patients With Type 2 Diabetes (2025) · cites this paper as [55]
A meta-analysis of 20 randomized controlled trials found walking interventions decreased A1c by 0.50% in diabetic participants, with supervised walking programs decreasing A1c by 0.58% and non-supervised walking with motivational strategies by 0.53%.
“A meta-analysis of 20 randomized control trials showed a decrease in A1c by 0.50% with walking interventions in diabetic participants, particularly in supervised walking programs (A1c decrease 0.58%) and non-supervised walking interventions using motivational strategies (A1c decrease 0.53%).”
From The Impact of Physical Activity in Patients With Type 2 Diabetes (2025) · cites this paper as [55]
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“Previous studies showed the effect of supervised aerobic exercise in patients with type 2 diabetes in western countries (5).”
BackgroundMasuda, H., Ishiyama, D., Yamada, M., Iwashima, F., Kimura, Y., Otobe, Y., Tani, N., Suzuki, M., & Nakajima, H. (2021) · Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy · doi:10.2147/dmso.s307070 · Cited by 6 · see citing works
- Authors
- Qiu, S., Cai, X., Schumann, U., Velders, M., Sun, Z., & Steinacker, J. M.
- Affiliations
- Universität Ulm (DE)
- Zhongda Hospital Southeast University (CN)
- Corresponding author
- Sun, Zilin
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2014-10-17
- Volume
- 9
- Issue
- 10
- Pages
- e109767
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC4201471
- OpenAlex
- W2095358310
- Cited by
- 128
- References
- 48
- Citations by year
- 2026: 8 · 2025: 9 · 2024: 9 · 2023: 11 · 2022: 10 · 2021: 15 · 2020: 15 · 2019: 13 · 2018: 14 · 2017: 9 · 2016: 7 · 2015: 8
- FWCI
- 0.94
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- walking, type 2 diabetes, glycemic control, HbA1c, cardiovascular risk factors, supervised exercise, motivational strategies, body mass index, blood pressure, lipoprotein cholesterol
- MeSH terms
- Blood Glucose, Blood Pressure, Body Weight, Cardiovascular Diseases, Diabetes Mellitus, Type 2, Exercise Therapy, Female, Glycated Hemoglobin, Humans, Male, Risk Factors, Case-Control Studies, Walking
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