Diabetes Care, Vol 18, Issue 6 775-778, Copyright © 1995 by American Diabetes Association

ARTICLES

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

K Yamanouchi, T Shinozaki, K Chikada, T Nishikawa, K Ito, S Shimizu, N Ozawa, Y Suzuki, H Maeno, K Kato and al. et
First Department of Internal Medicine, Aichi Medical University, Japan.

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 microU.min-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 greater than 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 mumol.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 x exercise, P = 0.0005) for the improvement of MCR. Significant correlations were also observed between delta 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.
CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				M. Shani, T. R. Taylor, S. Vinker, A. Lustman, R. Erez, A. Elhayany, and A. Lahad Characteristics of Diabetics with Poor Glycemic Control Who Achieve Good Control J Am Board Fam Med, November 1, 2008; 21(6): 490 - 496. [Abstract] [Full Text] [PDF]

				C. R. Richardson, T. L. Newton, J. J. Abraham, A. Sen, M. Jimbo, and A. M. Swartz A Meta-Analysis of Pedometer-Based Walking Interventions and Weight Loss Ann. Fam. Med, January 1, 2008; 6(1): 69 - 77. [Abstract] [Full Text] [PDF]

				S. F. E. Praet and L. J. C. van Loon Optimizing the therapeutic benefits of exercise in Type 2 diabetes J Appl Physiol, October 1, 2007; 103(4): 1113 - 1120. [Abstract] [Full Text] [PDF]

				K. K. Sato, T. Hayashi, H. Kambe, Y. Nakamura, N. Harita, G. Endo, and T. Yoneda Walking to Work Is an Independent Predictor of Incidence of Type 2 Diabetes in Japanese Men: The Kansai Healthcare Study Diabetes Care, September 1, 2007; 30(9): 2296 - 2298. [Full Text] [PDF]

				R. E. Wener and G. W. Evans A Morning Stroll: Levels of Physical Activity in Car and Mass Transit Commuting Environment and Behavior, January 1, 2007; 39(1): 62 - 74. [Abstract] [PDF]

				N. J. Snowling and W. G. Hopkins Effects of Different Modes of Exercise Training on Glucose Control and Risk Factors for Complications in Type 2 Diabetic Patients: A meta-analysis. Diabetes Care, November 1, 2006; 29(11): 2518 - 2527. [Abstract] [Full Text] [PDF]

				J. J. VanWormer, N. P. Pronk, and J. L. Boucher Experience Analysis of a Practice-Based, Online Pedometer Program Diabetes Spectr, October 1, 2006; 19(4): 197 - 200. [Full Text] [PDF]

				J. E Berlin, K. L Storti, and J. S Brach Using Activity Monitors to Measure Physical Activity in Free-Living Conditions Physical Therapy, August 1, 2006; 86(8): 1137 - 1145. [Full Text] [PDF]

				L. Engel and H. Lindner Impact of Using a Pedometer on Time Spent Walking in Older Adults With Type 2 Diabetes The Diabetes Educator, January 1, 2006; 32(1): 98 - 107. [Abstract] [Full Text] [PDF]

				S. D. Stovitz, J. J. VanWormer, B. A. Center, and K. L. Bremer Pedometers As a Means to Increase Ambulatory Activity for Patients Seen at a Family Medicine Clinic J Am Board Fam Med, September 1, 2005; 18(5): 335 - 343. [Abstract] [Full Text] [PDF]

				J. M Jakicic and A. D Otto Physical activity considerations for the treatment and prevention of obesity Am. J. Clinical Nutrition, July 1, 2005; 82(1): 226S - 229S. [Abstract] [Full Text] [PDF]

				M. Z. Strowski, Z. Li, D. Szalkowski, X. Shen, X.-M. Guan, S. Juttner, D. E. Moller, and B. B. Zhang Small-Molecule Insulin Mimetic Reduces Hyperglycemia and Obesity in a Nongenetic Mouse Model of Type 2 Diabetes Endocrinology, November 1, 2004; 145(11): 5259 - 5268. [Abstract] [Full Text] [PDF]

				F. Dela, M. E. von Linstow, K. J. Mikines, and H. Galbo Physical training may enhance {beta}-cell function in type 2 diabetes Am J Physiol Endocrinol Metab, November 1, 2004; 287(5): E1024 - E1031. [Abstract] [Full Text] [PDF]

				M. C. Whitt, K. D. DuBose, B. E. Ainsworth, and C. Tudor-Locke Walking Patterns in a Sample of African American, Native American, and Caucasian Women: The Cross-Cultural Activity Participation Study Health Educ Behav, August 1, 2004; 31(4_suppl): 45S - 56S. [Abstract] [PDF]

				H. Yokoyama, M. Emoto, T. Araki, S. Fujiwara, K. Motoyama, T. Morioka, H. Koyama, T. Shoji, Y. Okuno, and Y. Nishizawa Effect of Aerobic Exercise on Plasma Adiponectin Levels and Insulin Resistance in Type 2 Diabetes Diabetes Care, July 1, 2004; 27(7): 1756 - 1758. [Full Text] [PDF]

				Y. Sato, M. Nagasaki, N. Nakai, and T. Fushimi Physical Exercise Improves Glucose Metabolism in Lifestyle-Related Diseases Experimental Biology and Medicine, November 1, 2003; 228(10): 1208 - 1212. [Abstract] [Full Text] [PDF]

				F. B. Hu and J. E. Manson Walking: The Best Medicine for Diabetes? Arch Intern Med, June 23, 2003; 163(12): 1397 - 1398. [Full Text] [PDF]

				A. Kirk, N. Mutrie, P. MacIntyre, and M. Fisher Promoting physical activity in people with type 2 diabetes The British Journal of Diabetes & Vascular Disease, May 1, 2002; 2(3): 211 - 213. [PDF]

				K. A. McAuley, S. M. Williams, J. I. Mann, A. Goulding, A. Chisholm, N. Wilson, G. Story, R. T. McLay, M. J. Harper, and I. E. Jones Intensive Lifestyle Changes Are Necessary to Improve Insulin Sensitivity: A randomized controlled trial Diabetes Care, March 1, 2002; 25(3): 445 - 452. [Abstract] [Full Text] [PDF]

				M. J. Franz, J. P. Bantle, C. A. Beebe, J. D. Brunzell, J.-L. Chiasson, A. Garg, L. A. Holzmeister, B. Hoogwerf, E. Mayer-Davis, A. D. Mooradian, et al. Evidence-Based Nutrition Principles and Recommendations for the Treatment and Prevention of Diabetes and Related Complications Diabetes Care, January 1, 2002; 25(1): 148 - 198. [Full Text] [PDF]

				M. J. Franz, J. G. Pastors, H. Warshaw, and A. E. Daly Does "Diet" Fail? The Diabetes Educator, July 1, 2001; 27(4): 563 - 570. [PDF]

				D. G. Armstrong and A. J.M. Boulton Activity Monitors: Should We Begin Dosing Activity as We Dose a Drug? J Am Podiatr Med Assoc, March 1, 2001; 91(3): 152 - 153. [Full Text]

				A. Katsuki, Y. Sumida, E. C. Gabazza, S. Murashima, M. Furuta, R. Araki-Sasaki, Y. Hori, Y. Yano, and Y. Adachi Homeostasis Model Assessment Is a Reliable Indicator of Insulin Resistance During Follow-up of Patients With Type 2 Diabetes Diabetes Care, February 1, 2001; 24(2): 362 - 365. [Abstract] [Full Text]

				F. B. Hu, M. J. Stampfer, C. Solomon, S. Liu, G. A. Colditz, F. E. Speizer, W. C. Willett, and J. E. Manson Physical Activity and Risk for Cardiovascular Events in Diabetic Women Ann Intern Med, January 16, 2001; 134(2): 96 - 105. [Abstract] [Full Text] [PDF]

				C. E. Tudor-Locke, A. M. Myers, and N. W. Rodger Development of a Theory-Based Daily Activity Intervention for Individuals With Type 2 Diabetes The Diabetes Educator, January 1, 2001; 27(1): 85 - 93. [Abstract] [PDF]

				F. B. Hu, R. J. Sigal, J. W. Rich-Edwards, G. A. Colditz, C. G. Solomon, W. C. Willett, F. E. Speizer, and J. E. Manson Walking Compared With Vigorous Physical Activity and Risk of Type 2 Diabetes in Women: A Prospective Study JAMA, October 20, 1999; 282(15): 1433 - 1439. [Abstract] [Full Text] [PDF]

				P. J. Arciero, M. D. Vukovich, J. O. Holloszy, S. B. Racette, and W. M. Kohrt Comparison of short-term diet and exercise on insulin action in individuals with abnormal glucose tolerance J Appl Physiol, June 1, 1999; 86(6): 1930 - 1935. [Abstract] [Full Text] [PDF]

				E. J. Mayer-Davis, R. D'Agostino Jr, A. J. Karter, S. M. Haffner, M. J. Rewers, M. Saad, R. N. Bergman, and for the IRAS Investigators Intensity and Amount of Physical Activity in Relation to Insulin Sensitivity: The Insulin Resistance Atherosclerosis Study JAMA, March 4, 1998; 279(9): 669 - 674. [Abstract] [Full Text] [PDF]