THE EFFECTS OF DOWNHILL WALKING ON INSULIN SENSITIVITY, ARTERIAL HEALTH, MUSCLE STRENGTH AND FUNCTIONAL PHYSICAL FITNESS IN PEOPLE WITH TYPE 2 DIABETES MELLITUS

Exercise is effective in preventing and managing Type 2 Diabetes Mellitus (T2DM). However, a significant number of people do not exercise as they perceive exercise to be physically challenging. Eccentric exercise, a novel aerobic exercise modality is less metabolically demanding and has been shown to have positive effects on blood glucose levels, cardiovascular fitness, and muscle strength in healthy populations. This research was conducted to explore the impact of eccentric exercise, specifically downhill walking, on insulin sensitivity, arterial health, muscle strength, and physical functional fitness in individuals with T2DM. A 12-week randomised controlled trial was conducted to investigate the effects of downhill, level, and uphill walking on people with T2DM. Sedentary adult participants with T2DM were randomised to perform downhill walking (DW), level walking (LW), or uphill walking (UW) for 30 minutes twice a week for twelve weeks at a standard speed of 2.5km/hr. The primary outcome measure was glycosylated haemoglobin (HbA1c), while secondary measures included arterial stiffness, strength, and physical fitness. A significant reduction in HbA1c between baseline and 12 weeks was observed in the UW group However, per-protocol analysis showed a significant decrease in HbA1c in the DW group post-intervention as well. Central Systolic blood pressure significantly decreased between baseline and post-intervention in the DW group. Participants in DW group and UW group showed significant improvements in distance walked in 6MWT post-intervention. A significant increase in knee extensors isometric strength between baseline and 12 weeks was observed for the DW group only. DW was as effective as UW for improving insulin sensitivity and more effective than LW and UW for improving central systolic blood pressure, muscle strength and functional physical fitness. DW is a viable option for those seeking a less demanding form of exercise.