Department of Family Medicine.
Department of Family Medicine, University College Hospital, Ibadan.
Br J Gen Pract. 2018 Feb;68(667):e139-e145. doi: 10.3399/bjgp18X694613. Epub 2018 Jan 15.
In clinical practice, translating the benefits of a sustained physically active lifestyle on glycaemic control in patients with type 2 diabetes mellitus (T2DM) is difficult. A walking prescription may be an effective alternative.
To examine the effect of a 10 000 steps per day prescription on glycaemic control of patients with T2DM.
Forty-six adults with T2DM attending a general outpatient clinic were randomised into two equal groups. The intervention group was given goals to accumulate 10 000 steps per day for 10 weeks, whereas the control group maintained their normal activity habits.
Daily step count was measured with waist-mounted pedometer and baseline and endline average steps per day. Glycosylated haemoglobin (HbA1c), anthropometric, and cardiovascular measurements were also obtained. An intention-to-treat analysis was done.
The average baseline step count was 4505 steps per day for all participants, and the average step count in the intervention group for the last 4 weeks of the study period was higher by 2913 steps per day (95% confidence interval [CI] = 1274 to 4551, (2, 37.7) = 18.90, <0.001). Only 6.1% of the intervention group participants achieved the 10 000 steps per day goal. The mean baseline HbA1c was 6.6% (range = 5.3 to 9.0). Endline HbA1c was lower in the intervention group than in the control group (mean difference -0.74%, 95% CI = -1.32 to -0.02, = 12.92, = 0.015) after adjusting for baseline HbA1c. There was no change in anthropometric and cardiovascular indices.
Adherence to 10 000 steps per day prescription is low but may still be associated with improved glycaemic control in T2DM. Motivational strategies for better adherence would improve glycaemic control.
在临床实践中,很难向 2 型糖尿病 (T2DM) 患者传达积极生活方式对血糖控制的益处。步行处方可能是一种有效的替代方案。
研究每天 10000 步的处方对 T2DM 患者血糖控制的影响。
46 名在普通门诊就诊的 T2DM 成年人被随机分为两组。干预组被设定目标,每天行走 10000 步,持续 10 周,而对照组则保持正常的活动习惯。
使用腰部佩戴的计步器测量每天的步数,记录基线和终点的平均每天步数。还获得了糖化血红蛋白 (HbA1c)、人体测量和心血管测量值。进行意向治疗分析。
所有参与者的平均基线步数为每天 4505 步,研究期间最后 4 周干预组的平均步数每天增加 2913 步 (95%置信区间 [CI] = 1274 至 4551, (2, 37.7) = 18.90, <0.001)。只有 6.1%的干预组参与者达到了每天 10000 步的目标。基线 HbA1c 的平均值为 6.6% (范围为 5.3 至 9.0)。调整基线 HbA1c 后,干预组的终点 HbA1c 低于对照组 (平均差异 -0.74%,95%CI = -1.32 至 -0.02, = 12.92, = 0.015)。人体测量和心血管指数没有变化。
每天 10000 步的处方的依从性较低,但仍可能与 T2DM 患者的血糖控制改善相关。更好的依从性的激励策略可以改善血糖控制。