Abstract

Strong evidence demonstrates that low walking levels predict the development of type 2 diabetes and the development of diabetes-related complications and mortality among individuals with established type 2 diabetes. While large-scale observational studies have relied on self-reported weekly time spent walking as the main walking measure, some more recent studies have used step counters (pedometers and accelerometers) that measure steps throughout the day, both those performed ‘incidentally’ and those performed explicitly for exercise. Step counting has been shown to be effective in self-monitoring and goal setting in physical activity programs for type 2 diabetes and other chronic conditions. However, most of these programs are ‘not universally available.

In the Step Monitoring to improve ARTE Rial health trial (SMARTER; funded by the Canadian Institutes of Health Research), active arm participants tracked their step counts, reviewed their step count records with their doctors, and then set step targets; the doctor then provided a written and signed prescription. We showed that this approach led to higher step counts, lower hemoglobin A1C , and lower insulin resistance. Results have been published in the journal Diabetes, Obesity & Metabolism (2017) (open access).

During this presentation, we will discuss the evidence that led to the SMARTER trial, describe the SMARTER strategy, and the findings from the trial. We will also share some of the facilitators and barriers that we identified following the trial, through discussions with collaborating physicians and trial participants.