Study: Physician-Prescribed Step Counts Increase Daily Steps
According to a recent study, a physician-prescribed step count was associated with a 20% increase in the number of steps walked per day and positive changes in insulin resistance and hemoglobin A1c in patients with diabetes and hypertension.
The study included 347 participants with type 2 diabetes, hypertension, or both who were randomly assigned to an active or control group (mean age 60 years). Sixty-six percent of participants had type 2 diabetes, and 90% of patients had hypertension.
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Participants in the active group received a pedometer and were provided a written prescription for daily step counts by their physician at each visit over the course of 1 year. Step counts were individualized and increased accordingly with an overall goal of 3000 steps made per day. For the control group, patients were advised to engage in 30 to 60 minutes of physical activity per day.
Researchers evaluated the effects of step counts on carotid femoral pulse wave velocity (cfPWV), hemoglobin A1c, and other cardiometabolic indicators, and assessed insulin sensitivity with Homeostatis Model Assessment-Insulin Resistance in participants not receiving insulin therapy.
A total of 275 participants completed the final assessments.
Overall, researchers found that participants in the active group increased their daily step count by 1200 over 1 year, and had a 20% net increase in steps per day compared to the control group.
Participants with type 2 diabetes in the active group experienced a decrease in hemoglobin A1c compared to the control group, and participants in the active group not on insulin therapy showed a decline in insulin resistance. Results from the cfPWV tests were inconclusive.
“A simple physician-delivered step count prescription strategy incorporated into routine clinical practice can augment physical activity and confer some favorable cardiometabolic changes in sedentary overweight adults with type 2 diabetes and/or hypertension,” the researchers concluded.
However, while the prescribed steps were close to the 3000 per day target, there was a gap between the daily number of steps patients achieved and the amount prescribed, indicating a need for motivational support for patients, according to the researchers.
—Melissa Weiss
Reference:
Dasgupta K, Rosenberg E, Joseph L, et al. Physician step prescription and monitoring to improve ARTERial health (SMARTER): a randomized controlled trial in patients with type 2 diabetes and hypertension [published online February 22, 2017]. Diabetes Obes Metab. doi:10.1111/dom.12874.