Key result
Post-meal walking for 15-20 minutes daily resulted in a -0.05% reduction in HbA1c, which was not significantly different from the -0.19% reduction seen with a single prandial insulin injection.
Why the study?
Post-meal walking decreases postprandial hyperglycemia in type 2 diabetic patients, but had not been tested against an active treatment comparator.
Does post-meal walking improve HbA1c compared to one prandial insulin injection in type 2 diabetic patients who failed basal insulin?
RCT (n=14)
Open-label
Computerized generated block of 4 randomization
No
Does post-meal walking improve HbA1c compared to one prandial insulin injection in type 2 diabetic patients who failed basal insulin?
Absolute Event Rate: -0.05% vs -0.19%
Post-meal walking for 15-20 minutes daily did not significantly differ from a single prandial insulin injection in reducing HbA1c, though the overall magnitude of reduction was small.
Post-meal walking matches prandial insulin for HbA1c reduction in basal failure; extends lifestyle evidence while underscoring limited efficacy of both.
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.
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Suntornlohanakul et al. (2020) conducted an RCT in Type 2 diabetes (n=14). Post-meal walking vs. One prandial insulin injection (basal plus) was evaluated on Difference in HbA1c reduction from baseline. Post-meal walking for 15-20 minutes daily resulted in a -0.05% reduction in HbA1c, which was not significantly different from the -0.19% reduction seen with a single prandial insulin injection.
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