Healthcare providers advise, encourage, and now officially prescribe physical activity as a key treatment for diabetes. Physical activity works independently to reduce blood sugar, blood pressure, cholesterol, weight gain and inflammation, and works in combination with prescribed medication to dramatically improve chronic disease outcomes.

Yet in the light of all the overwhelming support for physical activity, the traditional clinic model is inactive and sedentary. Moreover, group appointments are also shown to add measurable benefits for outpatients with complex chronic conditions, such as diabetes.

Toronto East General Hospital Diabetes Group Walking Clinic was created to combine these two concepts, and to test the feasibility and acceptability of an outpatient diabetes group-walking clinic. The clinic offers patients with Type 2 diabetes a chance to take a walk with their diabetes specialist and nurse educator for their scheduled follow-up appointments every three months.
Aside from a more hands on approach of teaching and demonstrating diabetes management, there is an additional component of group appointments, which is also a new concept for specialists. Group appointments help patients build a support group of peers who are going through similar issues and learn from each other’s experiences. Patients, providers, research students, and clinical experts were all involved in the research/implementation of this new clinic.

Initial surveys established baseline data and ‘wish list’ ideas to shape the creation of the pilot clinic. Qualitative interviews of outpatients added to the evaluation of the first year, yielding encouraging and surprising results, such as an increase in physical activity outside of the clinic. Quantitative evaluations through metrics, such as sugar blood levels before and after the walking appointment are also continuously monitored. As data grows each month, the quantitative outcomes are examined for significance. Active meetings and other creative ways to move while working are currently being implemented in an array of business and private sector contexts. Healthcare organizations should consider moving forward with best sedentary-less practices, helping to set an example for the patients we serve.

Toronto East General Hospital always strives to provide patient centred care and this clinic is just another way the hospital has demonstrated its mandate to put patients first. This clinic is designed to be an active, participatory approach towards helping patients become healthier, rather than a passive dictatorial method. The primary benefit of the Toronto East General Hospital Diabetes Walking Clinic is not only to improve the health of the patients with Type 2 Diabetes, but also help patients to overcome the barriers to physical activity that they face in their daily life such as lack of time or access/funding for gym memberships. This clinic has affectively demonstrated that a 30-minute walk a day – the recommended level of physical activity – is achievable for many patients. The clinic is changing patients’ perception around physical activity, making them realize that it is not only beneficial, but also manageable.

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Title: Clinical Nurse Specialist

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