Effectiveness of a Pragmatic Education Program Designed to Promote Walking Activity in Individuals With Impaired Glucose Tolerance: A randomized controlled trial

OBJECTIVE: To investigate whether a pragmatic structured education program with and without pedometer use is effective for promoting physical activity and improving glucose tolerance in those with impaired glucose tolerance (IGT). RESEARCH DESIGN AND METHODS: Overweight and obese individuals with IGT were recruited from ongoing screening studies at the University Hospitals of Leicester, U.K. Participants were randomly assigned to one of three groups. Group 1 received a 3-h group-based structured education program designed to promote walking activity using personalized steps-per-day goals and pedometers. Group 2 received a 3-h group-based structured education program designed to promote walking activity using generic time-based goals. Group 3 received a brief information leaflet (control condition). Outcomes included an oral glucose tolerance test, standard anthropometric measures, ambulatory activity, and psychological variables. Follow-up was conducted at 3, 6, and 12 months. RESULTS: A total of 87 individuals (66% male, mean age 65 years) were included in this study. At 12 months, significant decreases in 2-h postchallenge glucose and fasting glucose of −1.31 mmol/l (95% CI −2.20 to −0.43) and −0.32 mmol/l (−0.59 to −0.03), respectively, were seen in the pedometer group compared with the control group. No significant improvements in glucose control were seen in those given the standard education program. CONCLUSIONS: This study suggests that a pragmatic structured education program that incorporates pedometer use is effective for improving glucose tolerance in those with IGT. This result is likely to have important implications for future primary care–based diabetes prevention initiatives.