PMID- 30510891 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20201001 IS - 2211-3355 (Print) IS - 2211-3355 (Electronic) IS - 2211-3355 (Linking) VI - 13 DP - 2019 Mar TI - A simple to implement and low-cost supervised walking programme in highly motivated individuals with or at risk for type 2 diabetes: An observational study with a pre-post design. PG - 30-36 LID - 10.1016/j.pmedr.2018.11.003 [doi] AB - This observational study with a pre-post design, conducted in two Dutch primary healthcare centres, aimed to evaluate the effect of a supervised walking programme in highly motivated individuals with or at risk for type 2 diabetes mellitus (T2DM). Those able and willing to walk at least 6 km, were invited for a 28-week walking programme (February to August 2017), in which participants walked in groups, once weekly under supervision of volunteer healthcare professionals. Changes in bodyweight, BMI, waist circumference, HbA1c, blood pressure, well-being, health status and patient activation were analysed using paired t-tests and the Wilcoxon signed-rank test. Fifty-six people were included (30 T2DM; 26 at risk), of whom 60.7% were female. Mean age was 60.6 years, median BMI 30.8 kg/m(2) and mean systolic blood pressure 146.9 mm Hg. Participants with T2DM had median HbA1c of 50.0 mmol/mol. Post-challenge, BMI had decreased to 29.7 kg/m(2), and waist circumference decreased 3.4 cm (95% CI 2.1-4.8), both p < 0.01. Systolic and diastolic blood pressure decreased significantly (mean difference 6.5 mm Hg (95% CI 1.6-11.3, p = 0.01) and 3.5 mm Hg (95% CI 1.0-6.0, p < 0.01), respectively). Participants with HbA1c >53 mmol/mol at baseline (n = 8), had median decrease in HbA1c of 6.5 mmol/mol (p = 0.03). Well-being, but not health status and patient activation, improved significantly. In conclusion, in highly motivated individuals with or at risk for T2DM, this simple to implement and low-cost, but intensive, volunteer-based supervised walking programme is favourable, and therefore, can be seen as an option for clinical programs to implement to support highly motivated patients. FAU - Hoogendoorn, Sonja W AU - Hoogendoorn SW AD - Julius Center of Health Sciences and Primary Care, Department of General Practice, University Medical Center Utrecht, Utrecht University, the Netherlands. FAU - Rutten, Guy E H M AU - Rutten GEHM AD - Julius Center of Health Sciences and Primary Care, Department of General Practice, University Medical Center Utrecht, Utrecht University, the Netherlands. FAU - Hart, Huberta E AU - Hart HE AD - Julius Center of Health Sciences and Primary Care, Department of General Practice, University Medical Center Utrecht, Utrecht University, the Netherlands. FAU - de Wolf, Cees AU - de Wolf C AD - Collaborating Health Centers Nijkerk, Nijkerk, the Netherlands. FAU - Vos, Rimke C AU - Vos RC AD - Julius Center of Health Sciences and Primary Care, Department of General Practice, University Medical Center Utrecht, Utrecht University, the Netherlands. AD - Leiden University Medical Center, Dept Public Health and Primary Care/LUMC-Campus The Hague, the Netherlands. LA - eng PT - Journal Article DEP - 20181107 PL - United States TA - Prev Med Rep JT - Preventive medicine reports JID - 101643766 PMC - PMC6260274 OTO - NOTNLM OT - BMI, body mass index OT - DBP, diastolic blood pressure OT - EMR, electronic medical record OT - EQ-VAS, EuroQol-visual analogue scale OT - HbA1c, glycosylated haemoglobin A1c OT - Lifestyle intervention OT - NC, Nijkerk Challenge OT - PAM-13, 13-item patient activation measure OT - Physical activity OT - Prevention OT - RCTs, randomised controlled trials OT - Real-life setting OT - SBP, systolic blood pressure OT - T2DM, type 2 diabetes mellitus OT - Type 2 diabetes mellitus OT - WHO-5, World Health Organization five well-being index OT - Walking EDAT- 2018/12/05 06:00 MHDA- 2018/12/05 06:01 PMCR- 2018/11/07 CRDT- 2018/12/05 06:00 PHST- 2018/05/07 00:00 [received] PHST- 2018/09/05 00:00 [revised] PHST- 2018/11/05 00:00 [accepted] PHST- 2018/12/05 06:00 [entrez] PHST- 2018/12/05 06:00 [pubmed] PHST- 2018/12/05 06:01 [medline] PHST- 2018/11/07 00:00 [pmc-release] AID - S2211-3355(18)30264-X [pii] AID - 10.1016/j.pmedr.2018.11.003 [doi] PST - epublish SO - Prev Med Rep. 2018 Nov 7;13:30-36. doi: 10.1016/j.pmedr.2018.11.003. eCollection 2019 Mar.