title: Implementation of interval walking training in patients with type 2 diabetes in Denmark: rationale, design, and baseline characteristics.
abstract: Promoting physical activity is a first-line choice of treatment for patients with type 2 diabetes (T2D). However, there is a need for more effective tools and technologies to facilitate structured lifestyle interventions and to ensure a better compliance, sustainability, and health benefits of exercise training in patients with T2D. The InterWalk initiative and its innovative application (app) for smartphones described in this study were developed by the Danish Centre for Strategic Research in T2D aiming at implementing, testing, and validating interval walking in patients with T2D in Denmark. The interval walking training approach consists of repetitive 3-minute cycles of slow and fast walking with simultaneous intensity guiding, based on the exercise capacity of the user. The individual intensity during slow and fast walking is determined by a short initial self-conducted and audio-guided fitness test, which combined with automated audio instructions strives to motivate the individual to adjust the intensity to the predetermined individualized walking intensities. The InterWalk app data are collected prospectively from all users and will be linked to the unique Danish nationwide databases and administrative registries, allowing extensive epidemiological studies of exercise in patients with T2D, such as the level of adherence to InterWalk training and long-term effectiveness surveys of important health outcomes, including cardiovascular morbidity and mortality. Currently, the InterWalk app has been downloaded by >30,000 persons, and the achieved epidemiological data quality is encouraging. Of the 9,466 persons providing personal information, 80% of the men and 62% women were overweight or obese (body mass index ≥25). The InterWalk project represents a contemporary technology-driven public health approach to monitor real-life exercise adherence and to propagate improved health through exercise intervention in T2D and in the general population.
authors.affiliation: Department of Infectious Diseases, Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; The Danish Diabetes Academy, Odense University Hospital, Odense, Denmark; Department of Infectious Diseases, Centre of Inflammation and Metabolism, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Mathias
authors.initials: M
authors.lastname: Ried-Larsen
authors.affiliation: The Danish Diabetes Academy, Odense University Hospital, Odense, Denmark; Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus Nord, Denmark.
authors.forename: Reimar W
authors.initials: RW
authors.lastname: Thomsen
authors.affiliation: Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus Nord, Denmark.
authors.forename: Klara
authors.initials: K
authors.lastname: Berencsi
authors.affiliation: Department of Infectious Diseases, Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Department of Endocrinology (Diabetes and Metabolism), Rigshospitalet, University of Copenhagen, Denmark.
authors.forename: Cecilie F
authors.initials: CF
authors.lastname: Brinkløv
authors.affiliation: Department of Infectious Diseases, Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Department of Endocrinology (Diabetes and Metabolism), Rigshospitalet, University of Copenhagen, Denmark.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Brøns
authors.affiliation: Department of Infectious Diseases, Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; CopenRehab, Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Laura S
authors.initials: LS
authors.lastname: Valentiner
authors.affiliation: Department of Infectious Diseases, Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Department of Infectious Diseases, Centre of Inflammation and Metabolism, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Kristian
authors.initials: K
authors.lastname: Karstoft
authors.affiliation: Department of Infectious Diseases, Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; CopenRehab, Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Henning
authors.initials: H
authors.lastname: Langberg
authors.affiliation: Department of Infectious Diseases, Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; The Danish Diabetes Academy, Odense University Hospital, Odense, Denmark; Department of Endocrinology (Diabetes and Metabolism), Rigshospitalet, University of Copenhagen, Denmark.
authors.forename: Allan A
authors.initials: AA
authors.lastname: Vaag
authors.affiliation: Department of Infectious Diseases, Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Department of Infectious Diseases, Centre of Inflammation and Metabolism, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Bente K
authors.initials: BK
authors.lastname: Pedersen
authors.affiliation: Department of Endocrinology, Odense University Hospital, Odense, Denmark.
authors.forename: Jens S
authors.initials: JS
authors.lastname: Nielsen
keywords: cell phones; exercise; telemedicine