Walking-Induced Metabolic Interventions in Adults with Type 2 Diabetes Mellitus: An Experimental Study in Odisha

Monalisa Khuntia; Hariballav Mahapatra; Damodar Jena; Surendra Kumar Jena; Manas Ranjan Behera; Priyanka Mishra

doi:10.55489/njcm.170720266562

Authors

Monalisa Khuntia KIIT School of Rural Management, Kalinga Institute of Industrial Technology (KIIT) Deemed to be University, Bhubaneswar, Odisha, India https://orcid.org/0009-0009-0361-7616
Hariballav Mahapatra Sevayan Diabetes Centre, Puri, Odisha, India https://orcid.org/0000-0001-9845-0509
Damodar Jena KIIT School of Rural Management, Kalinga Institute of Industrial Technology (KIIT) Deemed to be University, Bhubaneswar, Odisha, India https://orcid.org/0000-0002-5107-7572
Surendra Kumar Jena KIIT School of Rural Management, Kalinga Institute of Industrial Technology (KIIT) Deemed to be University, Bhubaneswar, Odisha, India https://orcid.org/0009-0002-4686-6320
Manas Ranjan Behera KIIT School of Public Health, Kalinga Institute of Industrial Technology (KIIT) Deemed to be University, Bhubaneswar, Odisha, India https://orcid.org/0000-0003-4785-5949
Priyanka Mishra KIIT School of Architecture & Planning, Kalinga Institute of Industrial Technology (KIIT) Deemed to be University, Bhubaneswar, Odisha, India https://orcid.org/0009-0009-1235-7086

DOI:

https://doi.org/10.55489/njcm.170720266562

Keywords:

Glycemic control, Lifestyle-based interventions, Immediate Metabolic Effects, Preventive healthcare, Community health outcomes

Abstract

Background: Walking is a simple, accessible form of physical activity recommended for glycemic control in type 2 diabetes mellitus (T2DM). Evidence on its immediate metabolic effects in community settings remains limited. The study was conducted to assess the immediate effects of a single walking session on anthropometric, physiological, and biochemical parameters among adults with T2DM.

Methods: A community-based quasi-experimental pre–post study was conducted among 108 adults with T2DM in Puri district, Odisha, India. Participants completed a supervised 1.2-km moderate-intensity walk after overnight fasting. Body weight, blood pressure, fasting blood glucose, and lipid profile were measured before and after the intervention. Paired and independent sample t-tests were used for analysis at a 5% significance level.

Results: Following walking, significant reductions were observed in body weight, systolic and diastolic blood pressure, blood glucose, total cholesterol, triglycerides, LDL, and VLDL levels, while HDL increased significantly (all p<0.05). Blood glucose declined from 180.2±45.0 to 168.6±41.8 mg/dL. Improvements were comparable across sex and age groups, with no significant between-group differences. Effect sizes were generally small, indicating modest but consistent acute benefits.

Conclusions: A single session of moderate-intensity walking produced immediate improvements in glycemic, cardiovascular, and lipid parameters among adults with T2DM. Walking represents a practical, low-cost strategy that can support diabetes self-management and cardiometabolic health.

References

Genitsaridi I, Salpea P, Salim A, Sajjadi SF, Tomic D, James S, et al. 11th edition of the IDF Diabetes Atlas: global, regional, and national diabetes prevalence estimates for 2024 and projections for 2050. Lancet Diabetes Endocrinol. 2026 Feb;14(2):149-156. DOI: https://doi.org/10.1016/S2213-8587(25)00299-2 PMid:41412135

Otoda T, Aihara KI, Takayama T. Redox Balance, Mitohormesis, and Organ Stress in Type 2 Diabetes Mellitus: Mechanistic Insights and the Therapeutic Role of SGLT2 Inhibitors. Diabetology. 2025 Oct 3;6(10):111. DOI: https://doi.org/10.3390/diabetology6100111

Bastaki S. Diabetes mellitus and its treatment. International journal of Diabetes and Metabolism. 2005 Mar;13(3):111-134. DOI: https://doi.org/10.1159/000497580

Sinha R, Priya A, Sinha A, Hifz Ur Rahman M. Prevalence of diabetes distress among type 2 diabetes mellitus patients in India: a systematic review and meta-analysis. Health Psychol Behav Med. 2024 Mar 5;12(1):2324091. DOI: https://doi.org/10.1080/21642850.2024.2324091 PMid:38450243 PMCid:PMC10916906

Wojujutari AK, Idemudia ES, Ugwu LE. Psychological resilience mediates the relationship between diabetes distress and depression among persons with diabetes in a multi-group analysis. Sci Rep. 2024 Mar 18;14(1):6510. DOI: https://doi.org/10.1038/s41598-024-57212-w PMid:38499620 PMCid:PMC10948786

Dhali B, Chatterjee S, Sundar Das S, Cruz MD. Effect of Yoga and Walking on Glycemic Control for the Management of Type 2 Diabetes: A Systematic Review and Meta-analysis. J ASEAN Fed Endocr Soc. 2023;38(2):113-122. DOI: https://doi.org/10.15605/jafes.038.02.20 PMid:38045671 PMCid:PMC10692414

Bassin SR, Srinath R. The impact of physical activity in patients with type 2 diabetes. American Journal of Lifestyle Medicine. 2025 Jan;19(1):147-161. DOI: https://doi.org/10.1177/15598276231180541 PMid:39822318 PMCid:PMC11733108

Małkowska P. Positive effects of physical activity on insulin signaling. Current issues in molecular biology. 2024 May 30;46(6):5467-5487. DOI: https://doi.org/10.3390/cimb46060327 PMid:38920999 PMCid:PMC11202552

Stephens NA, Brouwers B, Eroshkin AM, Yi F, Cornnell HH, Meyer C, et al. Exercise Response Variations in Skeletal Muscle PCr Recovery Rate and Insulin Sensitivity Relate to Muscle Epigenomic Profiles in Individuals With Type 2 Diabetes. Diabetes Care. 2018 Oct;41(10):2245-2254. DOI: https://doi.org/10.2337/dc18-0296 PMid:30072402

Wang C, Tang S. The effects of aerobic exercise on 24-hour mean blood glucose levels measured by continuous glucose monitoring in type 2 diabetes: a meta-analysis. Front Physiol. 2024 Dec 23;15:1496271. DOI: https://doi.org/10.3389/fphys.2024.1496271 PMid:39764380 PMCid:PMC11700982

Nesti L, Pugliese NR, Sciuto P, Natali A. Type 2 diabetes and reduced exercise tolerance: a review of the literature through an integrated physiology approach. Cardiovasc Diabetol. 2020 Sep 5;19(1):134. DOI: https://doi.org/10.1186/s12933-020-01109-1 PMid:32891175 PMCid:PMC7487838

Colberg SR, Sigal RJ, Yardley JE, Riddell MC, Dunstan DW, Dempsey PC, et al. Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes Association. Diabetes Care. 2016 Nov;39(11):2065-2079. DOI: https://doi.org/10.2337/dc16-1728 PMid:27926890 PMCid:PMC6908414

Basak M, Laskar MA. Pathophysiology, life style intervention and complications of Type-2 diabetes: A review. Journal of Applied Pharmaceutical Research. 2024 Jun 30;12(3):01-10. DOI: https://doi.org/10.69857/joapr.v12i3.482

Mokhtari Z, Gheshlagh RG, Kurdi A. Health-related quality of life in Iranian patients with type 2 diabetes: An updated meta-analysis. Diabetes Metab Syndr. 2019 Jan-Feb;13(1):402-407. DOI: https://doi.org/10.1016/j.dsx.2018.10.007 PMid:30641733

Messina G, Alioto A, Parisi MC, Mingrino O, Di Corrado D, Crescimanno C, et al. Experimental study on physical exercise in diabetes: pathophysiology and therapeutic effects. Eur J Transl Myol. 2023 Oct 10;33(4):11560. DOI: https://doi.org/10.4081/ejtm.2023.11560

Dempsey PC, Larsen RN, Sethi P, Sacre JW, Straznicky NE, Cohen ND, et al. Benefits for Type 2 Diabetes of Interrupting Prolonged Sitting With Brief Bouts of Light Walking or Simple Resistance Activities. Diabetes Care. 2016 Jun;39(6):964-972. DOI: https://doi.org/10.2337/dc15-2336 PMid:27208318

Senefeld JW, D'Astice SE, Harmer AR, Hunter SK. Increased Cardiovascular Response to a 6-Minute Walk Test in People With Type 2 Diabetes. Diabetes Spectr. 2020 Feb;33(1):104-110. DOI: https://doi.org/10.2337/ds19-0002 PMid:32116462 PMCid:PMC7026755

Saint-Maurice PF, Troiano RP, Bassett DR Jr, Graubard BI, Carlson SA, Shiroma EJ, et al. Association of Daily Step Count and Step Intensity With Mortality Among US Adults. JAMA. 2020 Mar 24;323(12):1151-1160. DOI: https://doi.org/10.1001/jama.2020.1382 PMid:32207799 PMCid:PMC7093766

Holmstrup M, Fairchild T, Keslacy S, Weinstock R, Kanaley J. Multiple short bouts of exercise over 12-h period reduce glucose excursions more than an energy-matched single bout of exercise. Metabolism. 2014 Apr 1;63(4):510-519. DOI: https://doi.org/10.1016/j.metabol.2013.12.006 PMid:24439242 PMCid:PMC3965589

Hu FB, Sigal RJ, Rich-Edwards JW, Colditz GA, Solomon CG, Willett WC, et al. Walking compared with vigorous physical activity and risk of type 2 diabetes in women: a prospective study. JAMA. 1999 Oct 20;282(15):1433-1439. DOI: https://doi.org/10.1001/jama.282.15.1433 PMid:10535433

Bellini A, Nicolò A, Bazzucchi I, Sacchetti M. The effects of postprandial walking on the glucose response after meals with different characteristics. Nutrients. 2022 Mar 4;14(5):1080. DOI: https://doi.org/10.3390/nu14051080 PMid:35268055 PMCid:PMC8912639

Garg RK, Sharma B. Walking transmutes the individual health system: diseases. International Journal of Contemporary Pediatrics. 2023 Jan;10(1):122-5. DOI: https://doi.org/10.18203/2349-3291.ijcp20223434

Kelly P, Williamson C, Niven AG, Hunter R, Mutrie N, Richards J. Walking on sunshine: scoping review of the evidence for walking and mental health. British journal of sports medicine. 2018 Jun 1;52(12):800-806. DOI: https://doi.org/10.1136/bjsports-2017-098827 PMid:29858467

Najafipour F, Mobasseri M, Yavari A, Nadrian H, Aliasgarzadeh A, Mashinchi Abbasi N, et al. Effect of regular exercise training on changes in HbA1c, BMI and VO2max among patients with type 2 diabetes mellitus: an 8-year trial. BMJ Open Diabetes Res Care. 2017 Nov 8;5(1):e000414. DOI: https://doi.org/10.1136/bmjdrc-2017-000414 PMid:29177050 PMCid:PMC5687538

Jayedi A, Zargar MS, Emadi A, Aune D. Walking speed and the risk of type 2 diabetes: a systematic review and meta-analysis. Br J Sports Med. 2024 Mar 13;58(6):334-342. DOI: https://doi.org/10.1136/bjsports-2023-107336 PMid:38050034

Álvarez-Barbosa F, Ramos-Munell J, Del Pozo-Cruz J, Del Pozo Cruz B, Ceballos-Sánchez JL, Gallardo-Gómez D. Optimal dose and effectiveness of different types of physical activity to improve blood pressure in people with type 2 diabetes mellitus: A systematic review and network meta-analysis. Rev Endocr Metab Disord. 2026 Feb;27(1):139-152. DOI: https://doi.org/10.1007/s11154-025-10005-6. Erratum in: Rev Endocr Metab Disord. 2026 Feb 16. DOI: https://doi.org/10.1007/s11154-025-10012-7 PMID: 41254326

Kanaley JA, Colberg SR, Corcoran MH, Malin SK, Rodriguez NR, Crespo CJ, et al. Exercise/Physical Activity in Individuals with Type 2 Diabetes: A Consensus Statement from the American College of Sports Medicine. Med Sci Sports Exerc. 2022 Feb 1;54(2):353-368. DOI: https://doi.org/10.1249/MSS.0000000000002800 PMid:35029593 PMCid:PMC8802999

Buffey AJ, Herring MP, Langley CK, Donnelly AE, Carson BP. The Acute Effects of Interrupting Prolonged Sitting Time in Adults with Standing and Light-Intensity Walking on Biomarkers of Cardiometabolic Health in Adults: A Systematic Review and Meta-analysis. Sports Med. 2022 Aug;52(8):1765-1787. DOI: https://doi.org/10.1007/s40279-022-01649-4 PMid:35147898 PMCid:PMC9325803

Ahmed A, Ismail S. Exercise and Type 2 Diabetes Mellitus. InType 2 Diabetes in 2025-From Long History to Near Outlook 2026 Jan 14. IntechOpen. DOI: https://doi.org/10.5772/intechopen.1011038

Athwale RM, Shukla MP. Effect of supervised nordic walking on glycemic control and maximal aerobic capacity in patients with type 2 diabetes mellitus: a randomized controlled trial. European Journal of Physiotherapy. 2025 Mar 4;27(2):106-111. DOI: https://doi.org/10.1080/21679169.2024.2354199