The potential of electric bicycles to improve the health of people with type 2 diabetes: a feasibility study

Aim
Adopting active travel could help people with type 2 diabetes to increase their daily physical activity, but levels of active travel are low in this population. Barriers to active travel such as distance and effort could be overcome by using electric bicycles (e-bikes) for journeys. This feasibility study aimed to explore whether e-cycling was acceptable, and could potentially improve the health of people with type 2 diabetes.

Methods
Twenty people with type 2 diabetes were recruited and provided with an e-bike for 20 weeks. Participants completed a submaximal fitness test at baseline and follow-up to measure predicted maximal aerobic power, and semi-structured interviews were conducted to assess the acceptability of using an e-bike. Participants wore a heart rate monitor and a GPS receiver in the first week of e-bike use to measure their heart-rate during e-cycling.

Results
Eighteen participants completed the study, cycling 21km per week (median (IQR) 21.4 (5.5-37.7)). Predicted maximal aerobic power increased by 10.9%. Heart rate during e-bike journeys was 74.7% of maximum, compared with 64.3% of maximum when walking. Participants used the e-bikes for commuting, shopping and recreation, and expressed how the e-bike helped them to overcome barriers to active travel/cycling, such as hills. Fourteen participants purchased an e-bike on study completion.

Conclusions
There was evidence that e-cycling was acceptable, could increase fitness and elicits a heart rate that may lead to improvements in cardiometabolic risk factors in this population. E-bikes have potential as a health-improving intervention in people with type 2 diabetes.