Prolonged walking may not significantly lower fasting blood sugar in patients with type 2 diabetes

The investigators found that at the end of the walking exercise, there was no significant change in fasting glucose. Also, no meaningful difference in fasting glucose was observed at any point up to 3 hours after exercise commencement. The study was published in medRxiv as a preprint and has not yet been peer-reviewed.

In many low-income countries, fasting blood sugar is widely used for assessing glycemic control in patients with diabetes, as HbA1c is often unavailable or unaffordable. In these settings, many people walk long distances to receive healthcare, but the impact of walking on fasting glucose in type 2 diabetes is unknown. Therefore, Anxious J. Niwaha, University of Exeter Medical School, Exeter, UK, and colleagues aimed to determine if prolonged walking affects the reliability of fasting plasma glucose as a measure of glycaemic control in a randomised crossover trial.

For this purpose, the investigators compared the change in glucose from baseline in the fasting state between walking on a treadmill at a predetermined speed of 4.5 km/hour for 1 hour and not walking (resting) in type 2 diabetes patients. The pre-specified primary outcome was glucose at 1 and 2 hours.

Forty-five noninsulin-treated adults with type 2 diabetes were enrolled, most (77.8%) were treated with sulfonylurea, with or without metformin, and all completed both visits. 46.7% were female, and the median age was 51.

The study revealed the following findings:

• Walking for 1 hour was not associated with changes in fasting glucose after 60 minutes of exercise or after an additional hour of rest.
• Compared with the resting visit, glucose change from baseline (pre-intervention) with exercise was –0.15mmol/L and –0.10mmol/L at 60 and 120 minutes, respectively.
• Glucose difference was similar across all other post-baseline time points.
• Walking was not associated with differences in overall post-baseline glycemia.
• In a mixed-effects model, there was no difference in glucose levels between visits over the 3 hours post-baseline. The addition of exercise to the model did not explain further variability in glucose levels.

"The study of Ugandan adults with noninsulin-treated type 2 diabetes showed that prolonged walking did not meaningfully affect fasting plasma glucose, implying that the reliability of fasting glucose for monitoring glycemia is unlikely to be altered in patients who walk to the clinic," the authors concluded.

Reference:

The impact of prolonged walking on fasting plasma glucose in type 2 diabetes: A Randomised controlled crossover study. Anxious J. Niwaha, Lauren R. Rodgers, Andrew T. Hattersley, Robert C Andrews, Beverley M. Shields, Moffat J. Nyirenda, Angus G. Jones. medRxiv 2023.02.20.23286165; doi: https://doi.org/10.1101/2023.02.20.23286165