Effect of type 2 diabetes on energy cost and preferred speed of walking

Although walking is the most commonly recommended activity for patients with type 2 diabetes (T2D), these patients walk daily less than their healthy peers and adopt a lower self-selected speed. It has been suggested that gait alterations observed in this population could be responsible for a higher metabolic rate (MR) during walking. Thus, the aim of this study was to compare relationship between MR, the energy cost of walking per unit of distance (Cw) and self-selected walking speed in T2D patients and healthy individuals.

We measured metabolic and spatiotemporal parameters for 20 T2D patients and 20 healthy control subjects, while they walked on a treadmill at different speeds (0.50-1.75 m s^-1) using a breath-by-breath gas analyzer and an inertial measurement unit, respectively.

Net MR was 14.3% higher for T2D patients on average across all speeds, and they preferred to walk 6.8% slower at their self-selected compared with their non-diabetics counterparts (1.33 vs. 1.42 m s^-1, respectively; p = 0.045). Both groups naturally walked at a self-selected speed close to their minimum gross Cw per distance, with similar values of minimum gross Cw (3.53 and 3.32 J kg^-1 m^-1 in T2D patients and control subjects, respectively).

When compared with healthy subjects, T2D patients walk with a higher MR at any given speed. Thus, the slower self-selected speed observed in T2D patients seems to correspond to the speed at which their gross energy cost per distance was minimized and allows T2D patients to walk at the same intensity than healthy subjects.