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The effect of time spent outdoors during summer on daily blood glucose and steps in women with type 2 diabetes

Journal of Behavioral Medicine
Molly B. Richardson, Courtney Chmielewski, Connor Y. H. Wu, Mary B. Evans, Leslie A. McClure, Kathryn W. Hosig, Julia M. Gohlke
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The online version of this article (https://​doi.​org/​10.​1007/​s10865-019-00113-5) contains supplementary material, which is available to authorized users.

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This study investigated changes in glycemic control following a small increase in time spent outdoors. Women participants with type 2 diabetes (N = 46) wore an iBUTTON temperature monitor and a pedometer for 1 week and recorded their morning fasting blood glucose (FBG) daily. They went about their normal activities for 2 days (baseline) and were asked to add 30 min of time outdoors during Days 3–7 (intervention). Linear mixed effects models were used to test whether morning FBG values were different on days following intervention versus baseline days, and whether steps and/or heat exposure changed. Results were stratified by indicators of good versus poor glycemic control prior to initiation of the study. On average, blood glucose was reduced by 6.1 mg/dL (95% CI − 11.5, − 0.6) on mornings after intervention days after adjusting for age, BMI, and ambient weather conditions. Participants in the poor glycemic control group (n = 16) experienced a 15.8 mg/dL decrease (95% CI − 27.1, − 4.5) in morning FBG on days following the intervention compared to a 1.6 mg/dL decrease (95%CI − 7.7, 4.5) for participants in the good glycemic control group (n = 30). Including daily steps or heat exposure did not attenuate the association between intervention and morning FBG. The present study suggests spending an additional 30 min outdoors may improve glycemic control; however, further examination with a larger sample over a longer duration and determination of mediators of this relationship is warranted.

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