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The effects of free-living interval-walking training on glycemic control, body composition, and physical fitness in type 2 diabetic patients: a randomized, controlled trial
Karstoft K, Winding K, Knudsen SH, Nielsen JS, Thomsen C, Pedersen BK, Solomon TPJ
Diabetes Care 2013 Feb;36(2):228-236
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To evaluate the feasibility of free-living walking training in type 2 diabetic patients and to investigate the effects of interval-walking training versus continuous-walking training upon physical fitness, body composition, and glycemic control. RESEARCHDESIGN ANDMETHODS: Subjects with type 2 diabetes were randomized to a control (n = 8), continuous-walking (n = 12), or interval-walking group (n = 12). Training groups were prescribed five sessions per week (60 min/session) and were controlled with an accelerometer and a heart-rate monitor. Continuous walkers performed all training at moderate intensity, whereas interval walkers alternated 3-min repetitions at low and high intensity. Before and after the 4-month intervention, the following variables were measured: VO2max, body composition, and glycemic control (fasting glucose, HbA1c, oral glucose tolerance test, and continuous glucose monitoring (CGM)). RESULTS: Training adherence was high (89 +/- 4%), and training energy expenditure and mean intensity were comparable. VO2max increased 16.1 +/- 3.7% in the interval-walking group (p < 0.05), whereas no changes were observedin the continuous-walking or control group. Body mass and adiposity (fat mass and visceral fat) decreased in the interval-walking group only (p < 0.05). Glycemic control (elevated mean CGM glucose levels and increased fasting insulin) worsened in the control group (p < 0.05), whereas mean (p = 0.05) and maximum (p < 0.05) CGM glucose levels decreased in the interval-walking group. The continuous walkers showed no changes in glycemic control. CONCLUSIONS: Free-living walking training is feasible in type 2 diabetic patients. Continuous walking offsets the deterioration in glycemia seen in the control group, and interval walking is superior to energy expenditure-matched continuous walking for improving physical fitness, body composition, and glycemic control.
Copyright American Diabetes Association. Reprinted with permission from The American Diabetes Association.

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