A geriatric walking clinic improves hemoglobin A1c and timed gait in older veterans with type 2 diabetes
Geriatric Nursing. 2021;42(2):566-569

A geriatric walking clinic helped improve hemoglobin A1c levels among older patients with type 2 diabetes.3 The authors showed that through face-to-face visits, providing patients with pedometers, weekly phone calls to check on steps per day, and providing encouragement, clinicians can help improve patient’s quality of life.

Commentary by Dr Baker:

Physical activity is part of first-line treatment for diabetes. With 25% of older adults diagnosed with diabetes, exercise in this age group is very important. The Centers for Disease Control and Prevention (CDC) recommends that older adults participate in moderate-intensity aerobic exercise for at least 150 minutes weekly.

The need for proper diabetes management cannot be overstated. Uncontrolled diabetes can cause irreparable harm to the eyes, heart, and kidneys. Older adults with diabetes exhibit greater decline in muscle strength and functional impairment and increased muscle mass loss than those without diabetes.

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Veterans 60 years and older receiving care at a regional Veterans’ health care system were invited to participate in a 6-week demonstration project, the Geriatric Walking Clinic. Before enrolling in the program, patients were screened for medical and functional conditions that would prohibit them from participation. Sixty-two patients completed the program. Participants received a pedometer at the initial face-to-face visit as well as weekly telephone calls and dietary counseling. They returned to the clinic 6 weeks later for a final face-to-face visit. The researchers monitored hemoglobin A1c (HbA1c) and timed gait (frailty marker).

At the end of the program, participants were encouraged to continue exercising and provided with community resources. Three months after baseline, significant improvements in HbA1c (P =.013), and timed gait (P <.001) were found.

Results of this study suggest benefits from a regular walking program. Advanced practice providers should emphasize the health benefits of mobility during care and wellness visits.


1.  Salamene LC, Martins LM, Lucchetti G, Lucchetti ALG. Factors associated with successful aging in Brazilian community-dwelling older adults: when physical health is not enough. Geriatric Nursing. 2021;42(2):372-378. doi:10.1016/j.gerinurse.2021.01.009

2. Henning-Smith C. Meeting the social needs of older adults in rural areasJAMA Health Forum. 2020;1(11):e201411. doi:10.1001/jamahealthforum.2020.1411

3. Jiwani R, Wang C-P, Orsak B, et al. A geriatrics walking clinic improves hemoglobin A1c and timed gait in older veterans with type 2 diabetesGeriatric Nursing. 2021;42(2):566-569. doi:10.1016/j.gerinurse.2020.10.001

This article originally appeared on Clinical Advisor