Pedometer- and accelerometer-based exercise in subjects with diabetes mellitus

Pedometers and accelerometers have recently become applicable for not only monitoring but increasing level of physical activity (PA). We summarize the effects of pedometer- and accelerometer-based exercise interventions on glucose metabolism in subjects with diabetes mellitus (DM).

We searched intervention studies that investigated the effects of step-defined exercise interventions using pedometers and accelerometers on the levels of glucose metabolism markers, such as plasma glucose and hemoglobin A1c (HbA1c), in adult subjects with type 2 DM. The study characteristics and findings of glucose metabolism markers were reviewed.

Of 16 eligible studies reviewed, significant improvements in glucose metabolism markers were found in the intervention group compared to that observed in the control group in six studies: the HbA1c level in four studies, both the HbA1c and plasma glucose levels in one study and continuous glucose monitoring in one study. Four of these six studies emphasized a significance of PA intensity in addition to PA amount. Five studies found a significant increase in the number of steps, but only one of these studies showed significant reductions in glucose metabolism markers. No studies demonstrated a dose-response relationship between changes in the number of steps and glucose metabolism markers.

Limited studies showed significant improvements in glucose metabolism markers and steps among subjects with type 2 DM. Future studies are needed regarding how to use pedometers and accelerometers to achieve improvements in glucose metabolism with increases in PA in such subjects, especially more focus on PA intensity.