Walking with Diabetes (WW-DIAB) programme a walking programme for Indonesian type 2 diabetes mellitus patients: A pilot randomised controlled trial

Objectives: This pilot study aimed to examine the feasibility and effectiveness of a pedometer-based walking programme in Indonesian type 2 diabetes mellitus patients. Methods: Feasibility was assessed by monitoring participant recruitment, retention, and adherence to the step-monitoring and recording instructions. Effectiveness was assessed in a pilot randomised controlled trial. Participants were type 2 diabetes mellitus patients randomly assigned to a pedometer-only (PED-only) group (n = 22) and a pedometer with text message support (PED+) group (n = 21). Outcomes were step counts, self-reported physical activity, social cognitive constructs, glycaemic parameters, and health-related quality of life. These were assessed at baseline, 12-week intervention, and 12weeks later. Longitudinal analyses using generalised estimating equations were carried out to assess treatment and time effects on study outcomes. Results: All but one participant (98%) attended 12- and 24-week data collection follow-ups. Throughout the study period, 82% of PED+ participants submitted their daily steps log. Daily steps increased in both groups (p<0.001) but more in the PED+ group (2064 more steps at week 24, 95% confidence interval: 200–3925, p=0.03). Self-reported physical activity levels and glycaemic parameters increased similarly in the two groups over time (p<0.05). Improvements in social cognitive processes were seen only in the PED+ group (p < 0.05). There were no significant improvements in health-related quality of life. Conclusion: This study provides preliminary evidence that a pedometer-based walking programme, with or without additional support, is feasible and improves physical activity and glucose levels in Indonesian type 2 diabetes mellitus patients. Greater increases in step counts can result from the provision of text message support and education materials than from the provision of a pedometer only.