Nordic Walking for Diabetes: Do the Poles Improve HbA1c?

Nordic walking can lower HbA1c in adults with prediabetes or type 2 diabetes—but no trial has shown that the poles lower it more than ordinary walking performed for the same amount of time and effort. That distinction decides whether Nordic walking is a useful way to exercise or a metabolic upgrade worth buying.

A 2026 systematic review and meta-analysis of six randomized controlled trials, including 321 adults with prediabetes or established type 2 diabetes, found that Nordic walking reduced HbA1c by an average of 0.37 percentage points versus control conditions. The result was statistically significant (p=0.0001), but the studies varied substantially: heterogeneity was high, with I²=69%. The review also found a 0.79 kg reduction in body weight (p=0.02) and a 0.07 mmol/L increase in HDL cholesterol (p=0.005). Those are real findings. They do not establish that poles beat walking.

What the evidence actually shows

The Chen et al. 2026 meta-analysis is the central evidence on Nordic walking and glycemic outcomes in people with prediabetes or diabetes. It pooled six randomized trials and compared Nordic walking with control conditions. The available evidence indicates those controls were sedentary or usual-care conditions rather than volume-matched conventional walking.

That makes the main result useful but narrower than the advertising copy on a box of poles might imply. Nordic walking beat doing little or no structured exercise. Exercise programs often do that. The review does not answer whether a person who already walks regularly would gain extra glucose control by adding poles.

HbA1c estimates average blood glucose exposure over roughly three months, so it is a more decision-relevant diabetes marker than a single fasting glucose measurement. Still, the pooled 0.37-point HbA1c reduction falls below the 0.5-point difference often used in clinical diabetes literature as a benchmark for a meaningful glycemic change. It is statistically significant, yet clinically modest.

The other pooled outcomes add restraint. Waist circumference decreased by 0.82 cm, but the result did not reach statistical significance (p=0.07). Fasting blood glucose, HOMA-IR, LDL cholesterol, triglycerides, and blood pressure did not change significantly. A lower HbA1c alongside unchanged fasting glucose and HOMA-IR is possible, but it is not a tidy metabolic story. Differences in trial duration, measurement windows, participant characteristics, or reporting could explain the pattern. The evidence does not identify the reason.

People with type 2 diabetes saw the larger average change

Chen and colleagues reported a larger HbA1c reduction in the type 2 diabetes subgroup: 0.49 percentage points (p<0.00001), compared with 0.20 points in the prediabetes subgroup (p=0.001). The type 2 diabetes estimate approaches the commonly cited 0.5-point clinical benchmark; the prediabetes estimate remains well below it.

That contrast is plausible because people starting with greater glycemic burden have more room for improvement. It should not become a prescription rule. The six trials contained only 321 people in total, or about 54 participants per trial on average, and the review did not examine several likely modifiers of response, including intervention duration, session frequency, baseline HbA1c, or diabetes duration.

Diabetes duration deserves particular attention. In the randomized 2024 INTENSITY study, longer-standing type 2 diabetes significantly reduced the glycemic response to an aerobic exercise intervention. Chen's subgroup analysis separated prediabetes from type 2 diabetes but did not account for how long participants had lived with diabetes. If the Nordic-walking trials enrolled people with relatively short-duration disease, the larger type 2 diabetes estimate may not apply to people with long-standing disease.

Do the poles themselves add anything?

Nordic walking has a reasonable physiological rationale. Using poles recruits the upper body, and the full-text report accompanying the 2026 review notes that Nordic walking can engage 70% to 90% of skeletal muscle. It may therefore raise oxygen use and energy expenditure compared with ordinary walking at a similar pace. Plausible is not the same as proven in the outcome that matters here: glycemic control.

The closest direct comparison is a 2021 randomized trial by Witkowska et al. comparing Nordic walking with conventional walking in healthy women older than 55. It assessed aerobic capacity and lipid profiles, not HbA1c, and it did not enroll people with prediabetes or diabetes. The study therefore cannot tell us whether poles provide a glucose-lowering premium in a metabolically compromised population.

No randomized trial has compared Nordic walking with conventional walking matched for walking volume and assessed glycemic endpoints in adults with prediabetes or diabetes. Until one does, no credible number exists for the incremental HbA1c benefit of the poles.

Why Nordic walking may still be a good choice

The practical argument for Nordic walking is stronger than the pole-specific metabolic argument. Poles can provide stability, distribute effort through the upper body, and make walking feel more manageable for some people. Those features may help someone exercise when unassisted walking feels unstable, painful, or dull enough to become a very expensive coat rack.

The 2024 VENERE study supports that practical use. It examined Nordic walking in an uncontrolled rehabilitation setting among obese or overweight adults with diabetes and cardiovascular disease. The program was feasible and well tolerated in this clinically complex group. Because it lacked a design that isolated the poles' effect, it cannot establish that Nordic walking caused metabolic improvements or outperformed standard walking. It does show that the activity can be workable in people for whom vigorous exercise may be inappropriate.

Related evidence supports giving people exercise options that fit their bodies and circumstances. A 2025 systematic review of alternative cardiac-rehabilitation exercises in women evaluated options that included Nordic walking and found that alternative formats could achieve similar completion rates and outcomes to traditional gym-based exercise. The review does not prove a diabetes-specific advantage for poles, but it supports a sensible clinical principle: an exercise format that a person can complete has value.

For prediabetes, the broader exercise literature also matters more than any single walking style. A 2022 network meta-analysis of exercise interventions in prediabetes compared aerobic, resistance, and combined exercise for glycemic control and insulin resistance. Nordic walking was not its main intervention, so it cannot rank poles against regular walking. It does place Nordic walking in its proper category: one aerobic option among several, rather than a separate metabolic technology.

What limits confidence in the current estimate

• The comparator is the central problem. The pooled trials compared Nordic walking with control conditions, not clearly with matched conventional walking. The evidence supports Nordic walking over inactivity or usual care, not superiority over walking.
• The evidence base is small. Six trials and 321 total participants leave limited room to test which people benefit most or whether small differences between walking styles are real.
• The main result varied across trials. HbA1c heterogeneity was substantial (I²=69%). Disease stage explained part of the variation, but several other likely reasons were not analyzed.
• The intervention was not standardized. Pole length, grip technique, and instruction varied across studies, so "Nordic walking" did not necessarily mean the same exposure in every trial.
• Generalizability is limited. About 63% of participants across the included trials were male, leaving less certainty for women, including postmenopausal women.
• Adherence data are missing. Claims that poles improve motivation, social connection, or long-term attendance remain plausible but unquantified in these diabetes trials.

Should you buy the poles?

Nordic walking is a reasonable aerobic exercise choice for adults with prediabetes or type 2 diabetes, especially when poles improve balance, confidence, comfort, or willingness to exercise. The best pooled evidence found a statistically significant 0.37-point HbA1c reduction versus control conditions, with a larger 0.49-point estimate in the type 2 diabetes subgroup. Those results justify using Nordic walking as exercise.

They do not justify choosing it over well-executed conventional walking for glycemic control. If you already walk consistently, the metabolic payoff from adding poles remains unmeasured. If poles help you walk farther, more often, or with greater confidence than you otherwise would, they can earn their place. The benefit then comes from doing more activity—not from evidence that the poles possess a special glucose-lowering trick.

Verdict: Nordic walking beats inactivity in the available trials. Whether it beats regular walking for HbA1c remains an unanswered question.