title: The effects of free-living interval-walking training on glycemic control, body composition, and physical fitness in type 2 diabetic patients: a randomized, controlled trial.
abstract: OBJECTIVE
  To evaluate the feasibility of free-living walking training in type 2 diabetic patients and to investigate the effects of interval-walking training versus continuous-walking training upon physical fitness, body composition, and glycemic control.
  
  
  METHODS
  Subjects with type 2 diabetes were randomized to a control (n = 8), continuous-walking (n = 12), or interval-walking group (n = 12). Training groups were prescribed five sessions per week (60 min/session) and were controlled with an accelerometer and a heart-rate monitor. Continuous walkers performed all training at moderate intensity, whereas interval walkers alternated 3-min repetitions at low and high intensity. Before and after the 4-month intervention, the following variables were measured: VO(2)max, body composition, and glycemic control (fasting glucose, HbA(1c), oral glucose tolerance test, and continuous glucose monitoring [CGM]).
  
  
  RESULTS
  Training adherence was high (89 ± 4%), and training energy expenditure and mean intensity were comparable. VO(2)max increased 16.1 ± 3.7% in the interval-walking group (P < 0.05), whereas no changes were observed in the continuous-walking or control group. Body mass and adiposity (fat mass and visceral fat) decreased in the interval-walking group only (P < 0.05). Glycemic control (elevated mean CGM glucose levels and increased fasting insulin) worsened in the control group (P < 0.05), whereas mean (P = 0.05) and maximum (P < 0.05) CGM glucose levels decreased in the interval-walking group. The continuous walkers showed no changes in glycemic control.
  
  
  CONCLUSIONS
  Free-living walking training is feasible in type 2 diabetic patients. Continuous walking offsets the deterioration in glycemia seen in the control group, and interval walking is superior to energy expenditure-matched continuous walking for improving physical fitness, body composition, and glycemic control.
authors.affiliation: Centre of Inflammation and Metabolism, Department of Infectious Diseases and CMRC, Rigshospitalet, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Kristian
authors.initials: K
authors.lastname: Karstoft
authors.forename: Kamilla
authors.initials: K
authors.lastname: Winding
authors.forename: Sine H
authors.initials: SH
authors.lastname: Knudsen
authors.forename: Jens S
authors.initials: JS
authors.lastname: Nielsen
authors.forename: Carsten
authors.initials: C
authors.lastname: Thomsen
authors.forename: Bente K
authors.initials: BK
authors.lastname: Pedersen
authors.forename: Thomas P J
authors.initials: TP
authors.lastname: Solomon
mesh_terms: D001786:Blood Glucose / Q000378:metabolism*; D001794:Blood Pressure / Q000502:physiology; D001823:Body Composition / Q000502:physiology*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000628:therapy*; D002149:Energy Intake / Q000502:physiology; D004734:Energy Metabolism / Q000502:physiology; D015444:Exercise / Q000502:physiology*; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010809:Physical Fitness / Q000502:physiology*; D016138:Walking / Q000502:physiology*
chemical_list: D001786:Blood Glucose