E-bike Riding And Cardiometabolic Health In Pre-diabetes Case Study

The prevalence of prediabetes may exceed 470 million in 2030 (Tabák et al. 2012). Physical activity (PA) can mitigate diabetes but adherence to consistent PA is poor (Poitras et al. 2018). Electric bikes (EB) are an appealing PA mode that may reduce risk of diabetes for those with prediabetes by improved blood glucose regulation and insulin resistance without the burden of pharmaceuticals. PURPOSE: Determine effects of riding an EB for 6 mo on blood glucose, insulin resistance, and other risk factors in a pre-diabetic adult. METHODS: Baseline values included pulse wave velocity (PWV), resting blood pressure, VO2max, body composition, resting blood lipids, glucose, HbA1c and insulin in a 70 yr old female referred by a physician with documented pre-diabetes. PA was measured by accelerometry and glucose by a continuous glucose monitor (CGM). All measurements were repeated at 3 mo and 6 mo during EB riding. RESULTS: 6 mo of riding an EB showed improvements in HbA1c (Pre = 6.1% vs. 3 mo (EB3)) = 5.7% vs. 6 mo ((EB6) = 5.7%), resting blood glucose (NB = 90 mg/dL vs. EB3 = 65 mg/dL vs. EB6 = 59 mg/dL), PWV (NB = 7.6 m/sec vs. EB3 = 6.9 m/sec vs. EB6 = 7.1 m/sec), % body fat (NB = 32.2% vs. EB3 = 31.6% vs. EB6 = 28.2%), and average resting blood pressure (NB = 126/76 vs. EB3 = 114/62 vs. EB6 = 119/65). With the EB, the average total number of steps per day increased (NB = 7095 ± 1066 (mean ± SD) vs. one week after riding the e-bike (EB1 = 7577 ± 146 vs. EB3 = 8433 ± 1089 vs. EB6 = 10749 ± 1940), Cycling time increased (NB = 0 ± 0 vs. EB1 = 10.04 ± 9.00 vs. EB3 = 13.18 ± 11.51 vs. EB6 = 13.05 ± 11.34 min), as well as activity score (NB = 33.93 ± 0.41 vs. EB1 = 34.19 ± 0.26 vs. EB3 = 34.36 ± 0.47 vs. EB6 = 35.19 ± 0.81 MET•h). The percentage of time points where blood glucose was above the normal healthy range (70 - 120 mg•dL-1) decreased over the 6 months after receiving the EB (NB = 24.39% vs. EB1 = 29.51% vs. EB3 = 23.26% vs. EB6 = 15.63%). CONCLUSION: 6 mo of riding an EB shows promising results for reducing risk of diabetes including improved blood glucose regulation, HbA1c, PWV, resting blood pressure, and % body fat, likely due to increased activity indicated by increased total number of steps, and cycling time, showing promise for this emerging and appealing mode of physical activity.