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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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“Similarly, success with simple pedometer interventions suggests that objective monitoring and step-count feedback can increase walking [21,34,35].”
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“It has been suggested that walking 10,000 steps per day would be adequate to meet the recommended 30 min of moderate physical activity five days per week (Yamanouchi et al., 1995), although pedometers are not able to measure the intensity of physical activity.”
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“In addition, regular walking improves cardiorespiratory fitness, body composition, HbA1c, lipid profiles, and insulin sensitivity (Walker et al. 1999; Yamanouchi et al. 1995).”
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BackgroundResultExercise Causes Muscle GLUT4 Translocation in an Insulin-Independent Manner
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Eastep, E., Beveridge, S. K., Eisenman, P. A., Ransdell, L. B., & Shultz, B. B. (2004) · Perceptual and Motor Skills · doi:10.2466/pms.99.2.392-402 · Cited by 31
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Activity Monitors: Should We Begin Dosing Activity as We Dose a Drug?
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“Besides, encouraging individuals who are motivated by weight reduction objectives to add a dietary component to their walking regimen may induce more weight reduction and hence may raise adherence (Jensen et al., 2004; Richardson et al., 2005; Yamanouchi et al., 1995).”
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“54,57,58 Small, randomized control studies suggest that interval walking may be more effective than continuous walking in patients with T2DM.”
Circulating leptin levels are associated with physical activity or physical fitness in Japanese
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“The advantages of regular PA in diabetes are: (1) better glycaemic control, (2) weight reduction and (3) improved insulin sensitivity.(8,9) The latter is integral to the prevention of cardiovascular complications, as impaired insulin activity can lead to elevated triglycerides, reduced high-density lipoprotein cholest…”
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MethodRelationship between peak oxygen uptake and regional body composition in Japanese subjects
Oda, K., Miyatake, N., Sakano, N., et al. (2013) · Journal of sport and health science/Journal of Sport and Health Science · doi:10.1016/j.jshs.2012.11.006 · Cited by 15
Plotnikoff, R. C., Courneya, K. S., Sigal, R. J., Johnson, J. A., Birkett, N., Lau, D., Raine, K. D., Johnson, S. T., & Karunamuni, N. D. (2010) · Trials · doi:10.1186/1745-6215-11-4 · Cited by 15
Lifestyle Interventions and the Prevention and Treatment of Type 2 Diabetes
Weber, M. B., Twombly, J. G., Narayan, K. M. V., & Phillips, L. S. (2010) · American Journal of Lifestyle Medicine · doi:10.1177/1559827610375531 · Cited by 17
Tokudome, M., Nagasaki, M., Shimaoka, K., & Sato, Y. (2004) · Geriatrics and gerontology international/Geriatrics & gerontology international · doi:10.1111/j.1447-0594.2004.00241.x · Cited by 15
Self-citationAssociation Between Walking and Low Back Pain in the Korean Population: A Cross-Sectional Study
Kim, H., Min, T. J., Kang, S. H., Kim, D., Seo, K. M., & Lee, S. Y. (2017) · Annals of Rehabilitation Medicine · doi:10.5535/arm.2017.41.5.786 · Cited by 14
“Walking may prevent several chronic medical issues [10,11], and walking speed is associated with survival in older adults [12].”
BackgroundSuzuki, M., Shindo, D., Kimura, M., & Waki, H. (2011) · International Journal of Sport Nutrition and Exercise Metabolism · doi:10.1123/ijsnem.21.3.222 · Cited by 14
Franz, M. J., Pastors, J. G., Warshaw, H. S., & Daly, A. E. (2001) · The Science of Diabetes Self-Management and Care · doi:10.1177/014572170102700411 · Cited by 13
Oshida, Y., Kako, M., Nakai, N., et al. (1999) · Endocrine Journal · doi:10.1507/endocrj.46.723 · Cited by 14
“Although physical exercise therapy has been shown to have a beneficial effect for the treatment of NIDDM [4, 5], the long-term continuation of this therapy in daily life is very difficult for NIDDM patients to achieve”
Self-citationThe Effect of Obesity Class on the Energetics and Mechanics of Walking
Primavesi, J., Menéndez, A. F., Hans, D. B., Favre, L., von Roten, F. C., & Malatesta, D. (2021) · Nutrients · doi:10.3390/nu13124546 · Cited by 13
“Walking is a common, accessible, and relatively safe type of physical activity [5,6], and is recommended for individuals with obesity to prevent obesity-related comorbidities [4].”
BackgroundYokochi, M., Watanabe, T., Ida, K., Yoshida, K., & Sato, Y. (2011) · Geriatrics and gerontology international/Geriatrics & gerontology international · doi:10.1111/j.1447-0594.2011.00790.x · Cited by 13
Self-citationManagement of Diabetic Dyslipidemia
Khera, A., & McGuire, D. K. (2005) · American Journal of Cardiovascular Drugs · doi:10.2165/00129784-200505020-00002 · Cited by 12
Modest weight loss improves insulin action in obese African Americans
Racette, S. B., Weiss, E. P., Hickner, R. C., & Holloszy, J. O. (2005) · Metabolism · doi:10.1016/j.metabol.2005.02.013 · Cited by 13
“Previous studies have shown improvements in insulin action in response to short-term (ie, 10day) diet [8] and exercise [8,27] interventions, after 6- to 14-week diet and exercise regimens [28,29] and after long-term (ie, 9-month) vigorous endurance exercise training [30].”
BackgroundEffects of current therapeutic interventions on insulin resistance
Kobayashi, M. (1999) · Diabetes Obesity and Metabolism · doi:10.1046/j.1463-1326.1999.0010s1032.x · Cited by 14
Actigraphy: The Ambulatory Measurement of Physical Activity
Tryon, W. W. (2011) · Springer eBooks · doi:10.1007/978-1-4614-0070-7_2 · Cited by 14
“Initial recommendations by Japanese investigators were for 10,000 steps per day to achieve general fitness (Hatano, 1993; Yamanouchi et al., 1995), which corresponds to approximately 300–400 calories per day (Hatano, 1997) depending upon walking speed, sex, age, and body size.”
BackgroundOverview of Exercise Prescription for Diabetes Patients and Its Application in Japan
Sato, Y. (2020) · Journal of Science in Sport and Exercise · doi:10.1007/s42978-020-00061-6 · Cited by 13
Self-citationde Oliveira, V. L. P., de Paula, T. P., & Viana, L. V. (2024) · Nutrition, Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2023.11.017 · Cited by 11
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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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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