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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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“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.”
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“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.”
From The Impact of Physical Activity in Patients With Type 2 Diabetes (2025) · cites this paper as [57]
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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 91
“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
Clinical aspects of physical exercise for diabetes/metabolic syndrome
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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 84
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 88
“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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Promoting Physical Activity among Sedentary Women Using Pedometers
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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].”
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“Ten thousand steps per day, in total daily activity, has been recommended for obtaining health benefits (24).”
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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 64
Walking to Work Is an Independent Predictor of Incidence of Type 2 Diabetes in Japanese Men
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“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
Metadata
- 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 › Public Health, Environmental and Occupational Health › 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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