DIABETES
February 28, 2017

"Take a Long Walk and Call Me in the Morning"

Being prescribed a step count can encourage patients with diabetes or high blood pressure to be more active. Just add a pedometer.

Exercise is often the best drug, but few doctors prescribe it to their patients. And even when they do, patients don't necessarily follow through.

Most of us know it's one thing to say that you're going to exercise more and another to actually do it. But what if your doctor prescribed a set number of steps that should be taken every day and gave you a pedometer to make keeping track of steps easy? That can help, a Canadian study has found.

At the end of a year those who were prescribed steps were walking an average of 1,200 more steps per day.

“As physicians, we have to face reality and admit that for many patients, just telling them to be more physically active simply doesn't work,” researcher, Kaberi Dasgupta, an Associate Professor of Medicine at McGill University and an attending physician at the McGill University Health Center, said in a statement. “A lot of people want to be active, but it is very difficult to change health behaviors. The idea in this study is to use step counts almost as a medication.”

A year after receiving their first step count prescription and pedometer, patients were walking 1,200 more steps a day.

Over 350 patients and 74 doctors from Montreal hospitals took part in the study. Patients either had type-2 diabetes, high blood pressure or both. Adults with type-2 diabetes are generally pretty sedentary, and the people in this study were averaging fewer than 5,000 steps a day — less than one hour's worth of walking — and that includes doing chores around the house and simply walking from room to room.

Patients were divided into two groups. Those in the control group were told to engage in 30-60 minutes of physical activity daily. People in the step count group were given a pedometer and a step count prescription, with the least active people told to increase their daily number of steps more slowly than those who were a bit more active. Patients in both groups saw their doctor once every three or four months; during these visits the pedometer records of the step count group were reviewed and a new step count prescription issued.

For example, someone walking 5,000 steps a day might be given a prescription to raise this to 5,750 a day by their next visit, at which time they'd get a new prescription for an even higher step count.

At the end of a year those who were prescribed steps were walking an average of 1,200 more steps per day. Those not given a step count and pedometer increased their daily step count by about 30.

Those patients given step count prescriptions who had diabetes also lowered their hemoglobin A1c, a measure of blood sugar. This measurement rose for patients in the control group. The same was true for insulin resistance.

Sometimes the first step really is the hardest one.

The study appears in Diabetes, Obesity, and Metabolism. It is freely available.

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