Walking training for intermittent claudication in diabetes

OBJECTIVE - Walking training (WT) is an established treatment for patients with intermittent claudication (IC). Abnormalities specific to diabetes, su ch as a relative preponderance of distal lesions and the contribution of mi crocirculatory disease, might well influence the results of WT. We compared changes in walking distance during WT in diabetic patients with those in n ondiabetic control subjects. RESEARCH DESIGN AND METHODS - In consecutive patients with limiting IC and proven peripheral vascular disease, 33 patients with diabetes were compared with 136 control subjects during a half-year supervised WT program. Walkin g parameters were determined every 2 months, while vascular parameters were obtained at the start and end of the program. RESULTS - Of the 33 diabetic patients, 25 (76%) completed the program, as d id 87 of the 136 (64%) control subjects. Thereafter, the symptom-free walki ng distance and the maximum walking distance (MWD) were significantly incre ased in diabetic patients from 142 +/- 30 to 339 +/- 57 m and from 266 +/- 39 to 603 +/- 52 m, respectively, and in control subjects from 176 +/- 8 to 400 +/- 39 m and from 292 +/- 18 to 628 +/- 36 m, respectively. The relati ve gain in MWD was 88% greater in those with diabetes. The vascular paramet ers were comparable for both groups before and after WT: CONCLUSIONS - WT is an effective treatment for IC, with a greater relative gain in diabetic patients.