Glycemic effect of post-meal walking compared to one prandial insulin injection in type 2 diabetic patients treated with basal insulin: A randomized controlled cross-over study.
Study Goal
The researchers aimed to compare the effect of post-meal walking versus one prandial insulin on glycemic control in type 2 diabetic patients who failed basal insulin therapy.
Results Summary
Post-meal walking showed a modest reduction in HbA1c and fructosamine levels, comparable to prandial insulin, but the differences were not statistically significant. The magnitude of glycemic improvement was small, suggesting similar but limited efficacy between the two interventions.
Population
Type 2 diabetic patients who failed basal insulin therapy.
Effective Dosage
15-20 minutes of walking after one meal per day.
Duration
6 weeks
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
post-meal walking | decrease | postprandial hyperglycemia | type 2 diabetic patients | - | decreases | #1 |
post-meal walking | decrease | HbA1c | type 2 diabetic patients who were being treated with basal insulin | -0.05(range:-1.08 to 0.74) % | reduced | #2 |
prandial insulin (basal plus) | decrease | HbA1c | type 2 diabetic patients who were being treated with basal insulin | -0.19(range:-0.8 to 0.56) % | reduced | #3 |
post-meal walking | decrease | HbA1c | type 2 diabetic patients who were being treated with basal insulin | 0.13(range:-0.74 to 1.08) % | decreased | #4 |
prandial insulin (basal plus) | decrease | HbA1c | type 2 diabetic patients who were being treated with basal insulin | 0.2(range:-0.56 to 0.8) % | decreased | #5 |
post-meal walking | no change | HbA1c reduction | type 2 diabetic patients who were being treated with basal insulin | - | no significant differences | #6 |
prandial insulin (basal plus) | no change | HbA1c reduction | type 2 diabetic patients who were being treated with basal insulin | - | no significant differences | #7 |
post-meal walking | decrease | Fructosamine levels | type 2 diabetic patients who were being treated with basal insulin | 17.5(-59 to 43) μmol/L | decreased | #8 |
post-meal walking | decrease | Fructosamine levels | type 2 diabetic patients who were being treated with basal insulin | 10(-15 to 40) μmol/L | decreased | #9 |
prandial insulin (basal plus) | decrease | Fructosamine levels | type 2 diabetic patients who were being treated with basal insulin | 12.5(-17 to 64) μmol/L | decreased | #10 |
prandial insulin (basal plus) | decrease | Fructosamine levels | type 2 diabetic patients who were being treated with basal insulin | 17.5(-28 to 38) μmol/L | decreased | #11 |
post-meal walking | no change | fructosamine reduction | type 2 diabetic patients who were being treated with basal insulin | - | no significant differences | #12 |
prandial insulin (basal plus) | no change | fructosamine reduction | type 2 diabetic patients who were being treated with basal insulin | - | no significant differences | #13 |
post-meal walking | decrease | glycemic control | type 2 diabetic patients who failed basal insulin | - | might be as effective as one prandial insulin to improve | #14 |
Studies demonstrate that post-meal walking decreases postprandial hyperglycemia in type 2 diabetic patients but it has never been tested with the active treatment comparator. The objective of this study was to determine the effect of post-meal walking on glycemic control compared with one prandial insulin in type 2 diabetic patients who failed basal insulin. A randomized controlled cross-over study of post-meal walking or one prandial insulin was done in type 2 diabetic patients who were being treated with basal insulin between May 2017 and March 2018. In post-meal walking group, patients walked after meal for 15-20 minutes one meal a day every day for 6 weeks. In prandial insulin (basal plus) group, one prandial insulin was injected before breakfast or main meal with rapid-acting insulin. The primary outcome was a difference in HbA1c reduction in post-meal walking compared with basal plus groups. Fourteen patients completed the study. By intention-to-treat analysis, HbA1c was reduced by -0.05(range:-1.08 to 0.74) and -0.19(range:-0.8 to 0.56) % in post-meal walking and basal plus groups respectively. By per-protocol analysis, post-meal walking and basal plus groups decreased HbA1c by 0.13(range:-0.74 to 1.08) and 0.2(range:-0.56 to 0.8) %, respectively. There was were no significant differences in HbA1c reduction from baseline in each group and between groups in both intention-to-treat and per-protocol analysis. Fructosamine levels were decreased by 17.5(-59 to 43) and 10(-15 to 40) μmol/L, respectively at 3 and 6 weeks in post-meal walking group whereas the respective changes in basal plus group were 12.5(-17 to 64) and 17.5(-28 to 38) μmol/L and there were no significant differences in fructosamine reduction from baseline in each group and between groups. In conclusion, although post-meal walking might be as effective as one prandial insulin to improve glycemic control in type 2 diabetic patients who failed basal insulin but the magnitude of reduction was small. A longer-term study with a larger sample size or with a different walking protocol is required.