Active Transport Planning Concept for Diabetes Self Management and Weight Reduction:Case Report

Abstract

Context: Sedentary lifestyle predisposes to diabetes and obesity, though these increases with age and is impacted by other ill-health conditions. Active travel such as bicycling and walking has positive impact in diabetes management. This autobiographical case report presents empirical data to advance considerations of active travel/mobility as epidemiological determinant of diabetes care outcome. Process ‘case report’: A 54-year-old Australian man lives with diabetes and works as a university academic. He weighed 110 Kg and desired to lose weight by riding bicycle and walking. However, the urban transport plan constituted a limiting factor, confounded by a 70 Km round-trip to work. Concerted effort was limited to 30 minutes a day and during this time, weight remained unchanged while fasting blood glucose at 7-8 mmol/L was managed with insulin injections. A breakthrough came upon switching job to another University town, with better road networks that provided for extensive bicycle lanes and walkways. Thus, the man rode bicycle 1hour round-trip to work and in 1year, his weight reduced to 107 Kg while glucose improved to <6.5 mmol/L. He went a step further and reduced bicycle riding to one day a working week and walked 90 minutes to work, totalling [3hours/day x 4days/week]. His weight further reduced to 104 Kg in 3 months while glucose control improved to <5.5 mmol/L he was taken off insulin, which was replaced with metformin once a day. Analysis: This case report presents measured changes in weight. Two points of thematic analysis are active transport and distance-to-work. Sustainable ‘active transport plan’ has enabled integration bicycle riding and walking into daily routines of DSM, But not at previous work environment. Also, new home address being 90 minutes walking distance-to-work relative to previous 70 Km round-trip is vital. Outcome: The affordances of active transport, and factor of distance-to-work need to be considered in educating the general population. This autobiographical case report shows empirical narrative of a man who struggles to lose weight. It advances active travel as an epidemiological factor to ensure healthy lives for individuals living with diabetes and/or obesity.