There has been active research and development of IWT, with approximately 8,700 individuals of overall good health participating in these studies. Details of the IWT are published elsewhere. Further, the aforementioned department also developed a triaxial accelerometer called JD Mate (Kissei Comtec, Matsumoto, Japan) that can easily estimate VO 2 peak. This was determined by the effect of increasing VO 2 peak almost plateaued at 50 minutes per week. Target exercise amounts are ≥ 60 minutes per week of fast walking time, which means 5–10 sets of 3 minutes of fast walking and 3 minutes of the slow walking a day for ≥ 4 days.
Interval walking involves repeating fast walking at ≥ 70% of the individual peak aerobic capacity (VO 2 peak) and slow walking at ≤ 40% VO 2 peak alternately for 3 minutes. The Department of Sports Medical Sciences, Shinshu University Graduate School of Medicine, developed a unique walking method termed interval walking training (IWT) in 1999.
Type 1 diabetes pilot professional#
Another reason for the low exercise uptake among people with T2D could be difficulty on the part of medical professional to teach positive habits, given the few established easy-to-perform protocols with evidence-based effects. This low practice rate could be attributed to low motivation, limited time availability, management problems, and lack of willpower or control. On the other hand, there is a low uptake of exercise, with 60% of adults with T2D not exercising at all. Accordingly, there are worldwide recommendations for performing both aerobic and resistance exercises. In recent years, combined aerobic and resistance exercises have reportedly enhanced muscle mass and strength, resulting in improved insulin resistance and more effective glycemic control compared to aerobic exercise alone. Exercise therapy and diet therapy form the basis of diabetes treatment and are required for most people with type 2 diabetes (T2D). The International Diabetes Federation estimated 450 million people with diabetes worldwide in 2019.
Type 1 diabetes pilot trial#
Trial registration: This trial was registered with the Japanese University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR: Usefulness on interval walking training in patients with type 2 diabetes. In future randomized controlled trial (RCT) studies, the detailed effects of IWT, focusing on these parameters, will be examined. IWT could be highly versatile and was suggested to have a positive effect on lipid metabolism and physical fitness. These results could be solely attributed to IWT since there were no significant differences in dietary intake and daily life energy consumption before and after the study.
Effect sizes were Cohen’s d = 0.25 of HDL-C, -0.55 of triglyceride, and 0.24 of VO 2 peak in the target achievement group, which were considered to be of small to medium clinical significance. However, in the target achievement group, a significant increase in VO 2 peak by 10% (from 1,682 mL/min to 1,827 mL/min, p = 0.037, t-test) was observed. In the primary outcome, HbA1c levels, and in the secondary, lipid metabolism and body composition, no significant changes were observed except for high-density lipoprotein cholesterol (HDL-C) (from 1.4 mmol/L to 1.5 mmol/L, p = 0.0093, t-test). All included participants completed IWT, with 39% of them reaching the target length of fast walking over 1,200 minutes in 20 weeks.
Between the start of IWT and after 20 weeks, we measured and evaluated changes in glucose and lipid metabolism data, body composition, physical fitness, muscle strength, dietary calorie intake, and daily exercise calories. The participants visited the hospital and were examined at 4-week intervals during this period. The target was 60 min/week of fast walking for 20 weeks. We enrolled 51 participants with T2D aged 20–80 years with glycohemoglobin (HbA1c) levels of 6.5–10.0% (48–86 mmol/mol) and a body mass index of 20–34 kg/m 2, respectively. We performed a single-arm interventional pilot study with IWT for 20 weeks. This pilot study aims to demonstrate descriptive statistics of IWT adherence and changes in various data before and after the intervention of IWT in adults with T2D, perform statistical hypothesis testing, and calculate effect sizes. A unique exercise regimen, interval walking training (IWT), has been reported to be beneficial for improving metabolic function, physical fitness and muscle strength in adults of overall health. There are few established easy-to-perform exercise protocols with evidence-based effects for individuals with type 2 diabetes (T2D).
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