Daily Walking Combined With Diet Therapy Is a Useful Means for Obese NIDDM Patients Not Only to Reduce Body Weight But Also to Improve Insulin Sensitivity
Abstract
OBJECTIVE: To evaluate the effects of walking combined with diet therapy (1,000–1,600 kcal/day) on insulin sensitivity in obese non-insulin-dependent diabetes mellitus (NIDDM) patients. RESEARCH DESIGN AND METHODS: Subjects were divided into two groups: 10 patients were managed by diet alone (group D), and 14 patients were placed in the diet and exercise group (group DE). Group DE was instructed to walk at least 10,000 steps/day on a flat field as monitored by pedometer (19,200 ± 2,100 steps/day), and group D was told to maintain a normal daily routine (4,500 ± 290 steps/day). A glucose clamp procedure at an insulin infusion rate of 40 mU · m−2 · min−1 was performed before and after the 6-; to 8-week training program. Mean serum insulin concentrations ranged from 720 to 790 pmol/l. RESULTS: While body weight (BW) in groups D and DE decreased significantly (P < 0.01) during the study, the amount of BW reduction in group DE was > that in group D (7.8 ± 0.8 vs. 4.2 ± 0.5 kg, P < 0.01). After training, glucose infusion rate (GIR) and metabolic clearance rate (MCR) in group D did not significantly increase; however, GIR and MCR increased significantly in group DE, from 17.21 ± 1.11 to 26.09 ± 1.11 μmol·kg−1 · min−1 (P < 0.001) and from 3.0 ± 0.3 to 5.3 ± 0.4 ml·kg−1 · min−1 (P < 0.001), respectively. The analysis of variance showed significant effects of exercise (time × exercise, P = 0.0005) for the improvement of MCR. Significant correlations were also observed between Δ MCR and average steps per day (r = 0.7257, P < 0.005) in group DE. CONCLUSIONS: Walking, which can be safely performed and easily incorporated into daily life, can be recommended as an adjunct therapy to diet treatment in obese NIDDM patients, not only for BW reduction, but also for improvement of insulin sensitivity.
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The observed reductions in the Sit Less group may have clinical relevance for individuals with diabetes and/or CVD, considering that reducing and replacing 30 minutes of sedentary time yields significant cardiometabolic benefits and reduces the risk of developing CVD and mortality.
“Considering that reducing and replacing 30 minutes of sedentary time yields significant cardiometabolic benefits and reduces the risk of developing CVD and mortality [21], the observed reductions in the Sit Less group may have clinical relevance for individuals with diabetes and/or CVD.”
Walking for an hour a day or walking at least 10,000 steps a day improves glycemic control and insulin sensitivity.
“Other studies have shown improvements in glycemic control and insulin sensitivity with walking for an hour a day or walking at least 10 000 steps a day.”
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Can Sustained Weight Loss in Overweight Individuals Reduce the Risk of Diabetes Mellitus?
Moore, L. L., Visioni, A. J., Wilson, P. W. F., D’Agostino, R. B., Finkle, W. D., & Ellison, R. C. (2000) · Epidemiology · doi:10.1097/00001648-200005000-00007 · Cited by 85 · see citing works
Pedometers As a Means to Increase Ambulatory Activity for Patients Seen at a Family Medicine Clinic
Stovitz, S. D., VanWormer, J. J., & Bremer, K. L. (2005) · The Journal of the American Board of Family Medicine · doi:10.3122/jabfm.18.5.335 · Cited by 86 · see citing works
Mechanical External Work and Recovery at Preferred Walking Speed in Obese Subjects
Malatesta, D., Vismara, L., Menegoni, F., Galli, M., Romei, M., & Capodaglio, P. (2009) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e31818606e7 · Cited by 84 · see citing works
Korkiakangas, E. E., Alahuhta, M. A., Husman, P. M., Keinänen‐Kiukaanniemi, S., Taanila, A. M., & Laitinen, J. H. (2011) · Scandinavian Journal of Caring Sciences · doi:10.1111/j.1471-6712.2010.00791.x · Cited by 81 · see citing works
Nonexercise Activity Thermogenesis in Obesity Management
Villablanca, P. A., Alegría, J. R., Mookadam, F., Holmes, D. R., Wright, R. S., & Levine, J. A. (2015) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2015.02.001 · Cited by 86 · see citing works
“With these technologies, it is easy to self-monitor and accomplish personal goals.(76) Evidence from studies showed a significant improvement not only in the average total steps but also in BMI and systolic and diastolic blood pressure.”
MethodThinness and weight loss: beneficial or detrimental to longevity?
Gaesser, G. A. (1999) · Medicine & Science in Sports & Exercise · doi:10.1097/00005768-199908000-00007 · Cited by 81 · see citing works
Clinical aspects of physical exercise for diabetes/metabolic syndrome
Sato, Y., Nagasaki, M., Kubota, M., Uno, T., & Nakai, N. (2007) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2007.01.039 · Cited by 81 · see citing works
Self-citationStep-Based Physical Activity Metrics and Cardiometabolic Risk
Tudor-Locke, C. E., Schuna, J. M., Han, H., Aguiar, E. J., GREEN, M. A., Busa, M. A., Larrivée, S., & Johnson, W. D. (2016) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000001100 · Cited by 81 · see citing works
Al-Mhanna, S. B., Rocha‐Rodrigues, S., Mohamed, M., Batrakoulis, A., Aldhahi, M. I., Afolabi, H. A., Yağın, F. H., Alhussain, M. H., Gülü, M., Abubakar, B. D., et al. (2023) · BMC Sports Science Medicine and Rehabilitation · doi:10.1186/s13102-023-00766-5 · Cited by 79 · see citing works
“As for the duration of interventions, one trial lasted two years [39], six trials lasted one year [32, 33, 37, 40, 41, 44], three trials lasted 24 weeks [35, 38, 42], one trial lasted 12 weeks [43], and two trials lasted eight weeks [34, 36].”
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The DASH Diet and Insulin Sensitivity
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“Similarly, studies examining the effects of exercise on glucose metabolism have produced mixed results [28–34].”
Pedometer Indices for Weekly Physical Activity Recommendations in Postmenopausal Women
JORDAN, A. N., JURCA, G. M., TUDOR-LOCKE, C., Church, T. S., & Blair, S. N. (2005) · Medicine & Science in Sports & Exercise · doi:10.1249/01.mss.0000177455.58960.aa · Cited by 73 · see citing works
“Ten thousand steps per day, in total daily activity, has been recommended for obtaining health benefits (24).”
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Carr, D. B., Utzschneider, K. M., Boyko, E. J., Asberry, P. J., Hull, R. L., Kodama, K., Callahan, H. S., Matthys, C. C., Leonetti, D. L., Schwartz, R. S., et al. (2005) · Diabetes · doi:10.2337/diabetes.54.2.340 · Cited by 69 · see citing works
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“As a consequence, it can be recommended as an adjunct therapy to diet treatment in type 2 diabetes patients [ 73 ].”
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EXERCISE MANAGEMENT OF OBESITY
Leermakers, E. A., Dunn, A. L., & Blair, S. N. (2000) · Medical Clinics of North America · doi:10.1016/s0025-7125(05)70229-7 · Cited by 65 · see citing works
Walking to Work Is an Independent Predictor of Incidence of Type 2 Diabetes in Japanese Men
Satō, K., Hayashi, T., Kambe, H., Nakamura, Y., Harita, N., Endo, G., & Yoneda, T. (2007) · Diabetes Care · doi:10.2337/dc07-0090 · Cited by 64 · see citing works
“Daily walking combined with diet have improved insulin sensitivity among subjects with diabetes (9), and aerobic exercise and a reduced-fat diet have improved insulin sensitivity among Japanese Americans with impaired glucose tolerance (10).”
Background
- Authors
- Yamanouchi, K., Shinozaki, T., Chikada, K., Nishikawa, T., Ito, K., Shimizu, S., Ozawa, N., Suzuki, Y., Maeno, H., Kato, K., Oshida, Y., & Sato, Y.
- Affiliations
- Nagoya University (JP)
- Aichi Medical University (JP)
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 1995-06-01
- Volume
- 18
- Issue
- 6
- Pages
- 775-778
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2011270818
- Cited by
- 330
- References
- 0
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 7 · 2023: 3 · 2022: 6 · 2021: 5 · 2020: 3 · 2019: 5 · 2018: 5 · 2017: 6 · 2016: 10 · 2015: 7 · 2014: 7 · 2013: 11 · 2012: 11
- FWCI
- 3.95
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- walking exercise, dietary therapy, obesity, type 2 diabetes, insulin sensitivity, weight loss, glucose infusion rate, metabolic clearance rate, pedometers, daily step count, glucose clamp, insulin resistance, type 2 diabetes management, insulin secretion, glucose metabolism
- MeSH terms
- Adult, Blood Glucose, Body Weight, Energy Intake, Combined Modality Therapy, Diabetes Mellitus, Diabetes Mellitus, Type 2, Diet, Diabetic, Diet, Reducing, Female, Glucose Tolerance Test, Humans, Infusions, Intravenous, Insulin, Male, Middle Aged, Obesity, Glucose Clamp Technique, Exercise, Body Mass Index, Walking
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