Increase your daily steps to ward off risk of diabetes


Dr Sanjay Kalra, DM (AIIMS); President-elect, SAFES, Bharti Hospital, Karnal, India    10 February 2022

Adding to the evidence about the beneficial health effects of walking, a recent study published in the journal Diabetes Care has found that with every 2000 extra steps taken every day, the risk of diabetes declined by 12% in older women.1

In this prospective study, Garduno et al examined 4838 women aged ≥65 years enrolled in the Objective Physical Activity and Cardiovascular Health (OPACH) study. Around 51% of them were aged 80 years or older. The participants were not diabetic at the time of their recruitment. Daily steps (total, light-intensity and moderate- to vigorous-intensity) were counted with research-grade accelerometers, worn by the participants over the right hip daily for one week except when bathing or swimming. They were also asked to maintain a sleep diary. The study participants were followed for a maximum period up to 7 years (median 5.7 years) to analyse the associations between total daily steps and incident diabetes.

Out of the 4838 women included in the study, 395 (8.1%) women developed diabetes.

The average number of daily steps was 3729; of which 1875 were light-intensity steps and 1854 steps were of moderate-to-vigorous intensity. The maximum number of steps taken per minute (step cadence) was 36 in a 30-minute period.

Overall, walking more steps per day was associated with decreased risk for incident diabetes. And this association was stronger for walking with moderate- to vigorous-intensity vs light-intensity steps. The hazard ratio (HR) for incident diabetes associated with a daily increment of 2,000 steps of light-intensity steps was 0.97 and for moderate- to vigorous-intensity steps, the HR was 0.86 in confounder adjusted models showing a weaker association with lower-intensity steps.

Factors like BMI, family history of diabetes, physical functioning had no impact on the association between daily steps and diabetes.

In its 2020 guidelines on physical activity, the World Health Organization (WHO) has said that “Some physical activity is better than doing none. By becoming more active throughout the day in relatively simple ways, people can easily achieve the recommended activity levels.”2

The findings of this study recapitulate the benefits of walking in preventing risk of type 2 diabetes in older adults. It also suggests that not just regular walking, but walking at moderate to vigorous intensity also helps in modifying this risk. For older adults, all steps count; hence, they also need to be active all through the day and not just for a specific period of time.

John Bellettiere, PhD, MPH, an assistant professor of epidemiology at the Herbert Wertheim School of Public Health and Human Longevity Science at the University of California, San Diego and coauthor aptly said. “For older adults, it is never too early to get active. In fact, this recommendation would hold for any adult. Starting now is the best recommendation.”


  1. Garduno AC, et al. Associations of Daily Steps and Step Intensity With Incident Diabetes in a Prospective Cohort Study of Older Women: The OPACH Study. Diabetes Care. 2022 Feb 1;45(2):339-347. doi: 10.2337/dc21-1202.
  2. Physical activity Fact Sheet, 26 November 2020, WHO.

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