Exercise with pedometer could cut risk of getting type 2 diabetes by half

19 January 2010

If people at risk of getting diabetes use a pedometer as part of a structured education programme they could reduce the chances of getting type 2 diabetes by more than 50 per cent, according to a new Diabetes UK-funded study[1].

The study assessed the effectiveness of the Prediabetes Risk Education and Physical Activity Recommendation and Encouragement (PREPARE) programme to see whether using a pedometer helps people to sustain increased physical activity levels. It involved 98 people with prediabetes — a precursor to Type 2 diabetes where you have raised blood glucose (sugar) levels

PREPARE offers a three-hour group education session about prediabetes and the role of a healthy lifestyle in preventing type 2 diabetes. For the study, a control group was given only a brief information leaflet, another group took part in the education session and another was given both the education session and a pedometer.

The pedometer group was helped to set personalised ‘steps-per-day’ targets, aimed at achieving at least 30 minutes of walking activity each day. All groups were followed up after three, six and 12 months.

Blood glucose levels, which were tested after participants ingested a standardised amount of sugar, were reduced by 15% in the pedometer group after a year compared to the control group.

This reduction was greater than that reported after one year in the most successful European and American studies of this kind. These studies did not include pedometer use but found that the risk of diabetes was reduced by up to 58% per cent over the longer term [2]. Therefore, the PREPARE researchers claim that if current results are sustained then their study will be at least as successful as this.

Dr Iain Frame, Research Director at leading health charity Diabetes UK, said: “Prediabetes affects an estimated seven million people in the UK and puts you at up to fifteen times more risk of developing type 2 diabetes.

“By finding new ways to educate and motivate people with prediabetes we are aiming to stop the type 2 diabetes epidemic in its tracks and prevent millions of people developing serious complications of the condition such as heart disease, stroke, kidney failure, blindness and amputation.

“This study shows that we can and must take action to prevent type 2 diabetes, particularly if the benefits can be shown in a larger number of people and over a sustained period of time.”

Lead researcher Dr Thomas Yates, from the Department of Cardiovascular Sciences at the University of Leicester, added: “Our study proves that using a pedometer as part of a structured education programme can really improve health outcomes for people with prediabetes.

“Using lifestyle interventions such as PREPARE to stop people developing Type 2 diabetes and its complications could save the NHS a fortune. This is particularly relevant to the Government’s Health Check Programme, which focuses on the prevention of vascular disease, including Type 2 diabetes.

“The impressive results of this study are already being recognised and the programme is now being implemented in Primary Care Trusts (PCTs) in England and Ireland. Longer-term evaluation of its impact continues both in these PCTs and in the original study participants.”

In 2006 Douglas Nichol, now 65, from Leicester, took part in the PREPARE programme after screening revealed his blood glucose levels to be high.

Douglas said: “There is, to the best of my knowledge, no history of diabetes in my family. I realised that at almost 15 stones I was overweight and I also had a BMI of 29, both additional risk factors for diabetes on top of the high blood pressure and heart attack.

“I was told that if I took the appropriate steps I could halve the risk of developing Type 2 diabetes — the fear factor was a major consideration for me in becoming as proactive as I have.

“I now weigh just over 12 and a half stones, more than two stones less than at the time of diagnosis, my BMI has fallen from 29 to 25 and I have briskly walked over 2,000 miles in the last year or so — around five miles a day. My last three blood glucose readings have been normal and I understand my risk of developing Type 2 diabetes has been reduced.”

There are 2.6 million people diagnosed with diabetes in the UK. Around 2.35 million of them have Type 2 diabetes and up to another 500,000 have the condition but don’t know it. Up to 80 per cent of Type 2 diabetes is preventable by adopting a healthy diet and increasing physical activity.

References

1. Yates T, Davies M, Gorely T, Bull F, Khunti K. (2009). Effectiveness of a pragmatic education program designed to promote walking activity in individuals with impaired glucose tolerance: a randomized controlled trial. Diabetes Care 32(8):1404-10.

2 Tuomilehto J. Lindstrom J. Eriksson JG. Valle TT. Hamalainen H. Ilanne-Parikka P. Keinanen-Kiukaanniemi S. Laakso M. Louheranta A. Rastas M. Salminen V. Uusitupa M. Finnish Diabetes Prevention Study Group. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance.[see comment]. [Clinical Trial. Journal Article. Multicenter Study. Randomized Controlled Trial. Research Support, Non-U.S. Gov't] The New England Journal of Medicine. 344(18):1343-50, 2001 May 3; and Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, Nathan DM & Diabetes Prevention Program Research Group , 2002. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin, The New England Journal of Medicine, 346, 393-403, 2002.