A geriatrics walking clinic improves hemoglobin A1c and timed gait in older veterans with type 2 diabetes

• Published in: Geriatric nursing (New York) 2021-03, Vol.42 (2), p.566-569
• Main Authors: Jiwani, Rozmin, Wang, Chen-Pin, Orsak, Beverly, MacCarthy, Daniel, Kellogg, Dean, Powers, Becky, Wang, Jing, Padala, Prasad, Padala, Kalpana, Espinoza, Sara
• Format: Article
• Language: English
• Subjects: Aged; Diabetes Mellitus, Type 2 - therapy; Female; Gait; Geriatrics; Glycated Hemoglobin - analysis; Glycemic control; Humans; Male; Physical activity; Type 2 diabetes; Veterans; Walking
• ISSN: 0197-4572; 1528-3984
• DOI: 10.1016/j.gerinurse.2020.10.001

Over one quarter of older adults in the U.S. has diabetes; and, physical activity is important for the promotion of healthy aging in this population. The purpose of this clinical demonstration project is to evaluate the effect of physical activity in the form of walking on glycemic control and timed gait in older Veterans with type 2 diabetes (T2D). Veterans aged ≥60 years were enrolled in the Geriatrics Walking Clinic (GWC), a clinical demonstration project, at South Texas Veterans Health Care System. GWC is a 6-week clinical program that promotes physical activity and is delivered by a registered nurse/diabetes educator and geriatrician. Veterans were recruited from the VA clinics. Enrolled patients received a pedometer at an initial face-to-face visit, were followed with weekly phone calls to monitor steps/day, received encouragement, and participated in a final face-to-face visit at the end of 6 weeks. In a sub-set of patients with T2D, we performed a chart review and recorded Hemoglobin A1c (HbA1c) at 3, 6, and 12 months after completion of the program. Timed Gait, a major characteristic of frailty, was measured at baseline and after completing the program. Change in HbA1c and timed gait compared to baseline was examined using paired t-tests. Sixty-two patients had HbA1c values available and were included in this analysis. Of these, 36, 52, and 61 patients had repeat HbA1c at 3, 6, and 12 months after the intervention, respectively. Mean age was 68 ± 6 years, 58% were Hispanic, and 92% males. HbA1c improved at 3 months (–0.49, 95% CI: –0.87 to –0.12, p=0.013), at 6 months (–0.40, 95% CI: –0.68 to –0.12, p=0.006), and at 12 months (–0.30, 95% CI: –0.57 to –0.029, p=0.031) compared to baseline. Timed Gait also improved (9.3 ±1.7 vs. 10.2 ±1.8, p