Impact of accelerometer and pedometer use on physical activity and glycaemic control in people with Type 2 diabetes: a systematic review and meta‐analysis

Background Self‐directed pedometer use increases physical activity levels in the general population; however, evidence of benefit for Type 2 diabetes is unclear and has not been systematically reviewed for accelerometers. Aim To examine the impact of using physical activity monitoring devices (pedometers and accelerometers) on free‐living physical activity and HbA1c levels in people with Type 2 diabetes. Methods We conducted a systematic literature review. Bibliographic databases included Medline, Embase, Web of Science, CINAHL, SportDiscus and the Cochrane Central Register of Controlled Trials. We included controlled trials evaluating interventions based on the use of pedometers or accelerometers to promote physical activity in people with Type 2 diabetes. Primary outcomes were physical activity (min/week or steps) and HbA1c [mmol/mol (%)]. Secondary outcomes were weight, blood pressure and lipid profile. Results Twelve trials (1458 participants) were identified, of which nine studied pedometers and three accelerometers. Random‐effects meta‐analysis showed an overall increase in physical activity (standardized mean difference 0.57, 95% CI 0.24, 0.91) in the intervention groups. Accelerometers and pedometers produced a similar effect size. No significant differences were observed in HbA1c, BMI, blood pressure or lipid profile. Conclusions People with Type 2 diabetes, provided with an accelerometer or pedometer, substantially increased their free‐living physical activity. There is no evidence that monitor use alone improves HbA1c or other clinical outcomes. Further trials are needed to compare the relative effects of activity monitors within differing complex interventions. What's new? The increasing popularity of physical activity monitors and the associated motivational effects on the wearer in the general population suggests a possible role within Type 2 diabetes management. This systematic review shows that activity monitor use increases free‐living physical activity in people with Type 2 diabetes, and suggests that accelerometers have a similar effect to pedometers despite functional differences. Together both types of monitor can initiate activity behaviour in sedentary users, on which to build additional interventions. Available trials, however, do not provide evidence that activity monitors alone produce significant improvement in clinical outcomes.