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Randomized Controlled Trial
. 2025 Mar;42(3):e15468.
doi: 10.1111/dme.15468. Epub 2024 Nov 9.

The impact of prolonged walking on fasting plasma glucose in type 2 diabetes: A randomised controlled crossover study

Anxious J Niwaha  1   2 , Beverley M Shields  1 , Lauren R Rodgers  3 , Andrew T Hattersley  1 , Robert C Andrews  1 , Moffat J Nyirenda  2   4 , Angus G Jones  1
Affiliations
Randomized Controlled Trial

The impact of prolonged walking on fasting plasma glucose in type 2 diabetes: A randomised controlled crossover study

Anxious J Niwaha et al. Diabet Med. 2025 Mar.

Abstract

Aims: In many low-income countries, fasting glucose is the primary measure for monitoring glycaemic control. Many patients in these countries walk long distances to the clinic, but the impact of walking on fasting glucose in type 2 diabetes is unknown. We aimed to determine the impact of walking on fasting glucose in people with type 2 diabetes.

Methods: In a randomised crossover trial, the change in glucose from baseline in the fasting state was compared between walking on a treadmill at a predetermined speed of 4.5 km/h for 1 h and not walking (resting) in people with type 2 diabetes.

Results: In all, 45 participants were enrolled and all completed both visits; 21/45 (46.7%) were women, and the median age was 51. Glucose during and after walking was similar to glucose while at rest; the glucose difference (walking minus rest) was -0.15 (95% CI: -0.55, 0.26) and -0.10 (95% CI: -0.50, 0.31) mmol/L at 1 and 2 h, respectively, p > 0.4 for both.

Conclusions: Fasting plasma glucose is not meaningfully affected by prolonged walking in participants with type 2 diabetes; therefore, the reliability of fasting glucose for monitoring glycaemic burden is unlikely to be altered in patients who walk to the clinic.

Keywords: exercise; fasting glucose; randomised crossover trial; type 2 diabetes.

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Conflict of interest statement

The authors declare that they have no known competing interests.

Figures

FIGURE 1
FIGURE 1
Participant flow chart. Participants attended two study visits: Treadmill visit; participant walks on a treadmill at a speed of 4.5 km/h for 60 min and then rests for the next 2 h, resting visit; participant rests for 3 h with minimal activity. The primary outcome was a change in fasting glucose between the walking and rest visit at 1 and 2‐h post‐treatment.
FIGURE 2
FIGURE 2
Mean difference (with 95% CIs) in glucose change from baseline between the exercise (walking) and resting visits. Y‐axis shows the difference in glucose change from baseline between the exercise and rest visits (exercise minus rest). The X‐axis shows time in minutes from baseline (0 min) up to 180 min from the start of the visits.
FIGURE 3
FIGURE 3
Glucose trends between the exercise (blue diamonds) and resting visit (black circles) after adjusting for the baseline differences between the two visits. The error bars denote 95% confidence intervals.
See this image and copyright information in PMC

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