Diabetology International

, Volume 7, Issue 2, pp 119–123 | Cite as

Acute effect of fast walking on postprandial blood glucose control in type 2 diabetes

  • Kenichi Deguchi
  • Tetsuya EnishiEmail author
  • Nori Sato
  • Hajime Miura
  • Yuichi Fujinaka
  • Munehide Matsuhisa
  • Shinsuke Katoh
Original Article



Several guidelines have recently recommended exercise for prevention and treatment of type 2 diabetes. However, determining the optimum exercise conditions, e.g., the intensity, amount, frequency, and type of exercise, is difficult, particularly by patients themselves. We have investigated the acute effect of fast walking on postprandial blood glucose levels among patients with type 2 diabetes.


Fourteen patients diagnosed with type 2 diabetes at least 1 year previously were eligible for inclusion in this study during educational hospitalization. Three walking programs, natural walking (walking at a natural speed), 10 % fast walking, and 20 % fast walking, were performed 1 h after lunch in a randomized sequence with a washout period of 1 day. Walking time was 30 min in all the programs. Primary outcome was determined by self-monitoring of blood glucose. Blood glucose levels were measured before walking, after walking for 15 min, and at the end of walking. Heart rate and systolic and diastolic pressure were also measured for safety reasons.


All the participants completed the study with no adverse effects. Compared with natural walking, fast walking markedly improved postprandial glucose excursion in an intensity-dependent manner without any adverse effects.


Fast walking acutely reduced postprandial blood glucose levels among patients with type 2 diabetes. Our method has major implications for the practice of diabetes education in clinical rehabilitation.


Fast walking Type 2 diabetes Postprandial glucose levels Rehabilitation Oxygen uptake 



This work was partly supported with by Grant-in-Aid for Medical and Dental Research from General Incorporated Associations Kojinkai.

Conflict of interest

Authors KD, TE, NS, HM, YF, MM, and SK declare that they have no conflict of interest.

Ethical standard

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions.

Informed consent

Informed consent was obtained from all patients before inclusion in the study.


  1. 1.
    Stumvoll M, Goldstein BJ, van Haeften TW. Type 2 diabetes: principles of pathogenesis and therapy. Lancet. 2005;365(9467):1333–46.CrossRefPubMedGoogle Scholar
  2. 2.
    Stratton IM, Adler AI, Neil HA, Matthews DR, Manley SE, Cull CA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ. 2000;321(7258):405–12.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Moreno G, Mangione CM. Management of cardiovascular disease risk factors in older adults with type 2 diabetes mellitus: 2002–2012 literature review. J Am Geriatr Soc. 2013;61(11):2027–37.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Turner RC, Holman RR, Cull CA, Stratton IM, Matthews DR, Frighi V, et al. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet. 1998;352(9131):837–53.CrossRefGoogle Scholar
  5. 5.
    Stearne MR, Palmer SL, Hammersley MS, Franklin SL, Spivey RS, Levy JC, et al. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. Brit Med J. 1998;317(7160):703–13.CrossRefGoogle Scholar
  6. 6.
    Stewart KJ. Exercise training and the cardiovascular consequences of type 2 diabetes and hypertension: plausible mechanisms for improving cardiovascular health. JAMA, J Am Med Assoc. 2002;288(13):1622–31.CrossRefGoogle Scholar
  7. 7.
    Colberg SR, Sigal RJ, Fernhall B, Regensteiner JG, Blissmer BJ, Rubin RR, et al. Exercise and type 2 diabetes: the American College of Sports Medicine and the American Diabetes Association: joint position statement. Diabetes Care. 2010;33(12):e147–67.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    American Diabetes A. Standards of medical care in diabetes—2013. Diabetes Care. 2013;36(Suppl 1):S11–66.CrossRefGoogle Scholar
  9. 9.
    Sone H, Tanaka S, Iimuro S, Tanaka S, Oida K, Yamasaki Y, et al. Long-term lifestyle intervention lowers the incidence of stroke in Japanese patients with type 2 diabetes: a nationwide multicentre randomised controlled trial (the Japan Diabetes Complications Study). Diabetologia. 2010;53(3):419–28.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Jeon CY, Lokken RP, Hu FB, van Dam RM. Physical activity of moderate intensity and risk of type 2 diabetes. Diabetes Care. 2007;30(3):744–52.CrossRefPubMedGoogle Scholar
  11. 11.
    Morrato EH, Hill JO, Wyatt HR, Ghushchyan V, Sullivan PW. Physical activity in US adults with diabetes and at risk for developing diabetes, 2003. Diabetes Care. 2007;30(2):203–9.CrossRefPubMedGoogle Scholar
  12. 12.
    Boule NG, Haddad E, Kenny GP, Wells GA, Sigal RJ. Effects of exercise on glycemic control and body mass in type 2 diabetes mellitus—a meta-analysis of controlled clinical trials. Jama J Am Med Assoc. 2001;286(10):1218–27.CrossRefGoogle Scholar
  13. 13.
    Johnson ST, McCargar LJ, Bell GJ, Tudor-Locke C, Harber VJ, Bell RC. Walking faster: distilling a complex prescription for type 2 diabetes management through pedometry. Diabetes Care. 2006;29(7):1654–5.CrossRefPubMedGoogle Scholar
  14. 14.
    Oberlin DJ, Mikus CR, Kearney ML, Hinton PS, Manrique C, Leidy HJ, et al. One bout of exercise alters free-living postprandial glycemia in type 2 diabetes. Med Sci Sports Exerc. 2014;46(2):232–8.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    van der Heijden MM, van Dooren FE, Pop VJ, Pouwer F. Effects of exercise training on quality of life, symptoms of depression, symptoms of anxiety and emotional well-being in type 2 diabetes mellitus: a systematic review. Diabetologia. 2013;56(6):1210–25.CrossRefPubMedGoogle Scholar
  16. 16.
    Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte MJ, Lee IM, et al. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc. 2011;43(7):1334–59.CrossRefPubMedGoogle Scholar
  17. 17.
    Johnson ST, Tudor-Locke C, McCargar LJ, Bell RC. Measuring habitual walking speed of people with type 2 diabetes: are they meeting recommendations? Diabetes Care. 2005;28(6):1503–4.CrossRefPubMedGoogle Scholar
  18. 18.
    Miyai N, Arita M, Miyashita K, Morioka I, Shiraishi T, Nishio I. Blood pressure response to heart rate during exercise test and risk of future hypertension. Hypertension. 2002;39(3):761–6.CrossRefPubMedGoogle Scholar
  19. 19.
    Benhalima K, Mathieu C. The role of blood glucose monitoring in non-insulin treated type 2 diabetes: what is the evidence? Prim Care Diabetes. 2012;6(3):179–85.CrossRefPubMedGoogle Scholar

Copyright information

© The Japan Diabetes Society 2015

Authors and Affiliations

  • Kenichi Deguchi
    • 1
    • 2
  • Tetsuya Enishi
    • 1
    Email author
  • Nori Sato
    • 1
  • Hajime Miura
    • 3
  • Yuichi Fujinaka
    • 4
  • Munehide Matsuhisa
    • 5
  • Shinsuke Katoh
    • 1
  1. 1.Department of Rehabilitation MedicineThe Tokushima University HospitalTokushimaJapan
  2. 2.Department of Rehabilitation MedicineThe Naruto Prefecture HospitalTokushimaJapan
  3. 3.Laboratory for Applied Physiology, Institute of Socio-Arts and ScienceUniversity of TokushimaTokushimaJapan
  4. 4.Department of Internal MedicineThe Naruto Prefecture HospitalTokushimaJapan
  5. 5.Clinical Research Center for DiabetesTokushima UniversityTokushimaJapan

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