Home-Based Walking Study in Older Adults With Type 2 Diabetes

Inclusion Criteria: * Type 2 diabetes for at least 5 years treated with diet alone or oral agents * Nonsmoker for at least 5 years * Subjects must be sedentary (as defined by no strength training and less than 30 minutes brisk walking/moderate exercise per week and no vigorous exercise in the preceding 6 months) * All subjects will have a fasting glucose of \<12 mM and a hemoglobin A1c \< 8.5% * Orthostatic hypotension defined as a decrease in systolic blood pressure of at least 20 mm Hg or diastolic blood pressure of at least 10 mm Hg within 3 minutes of assuming an upright posture on the initial screening visit as per current American Academy of Neurology guidelines. Exclusion Criteria: * Abnormalities on complete blood count, electrolytes or creatinine, on resting ECG, treadmill exercise stress test * Significant pulmonary, exercise-limiting orthopedic or neurological impairment * Evidence of valvular disease, exercise-induced syncope, angina, arrhythmias or peripheral vascular disease * Poor blood pressure control as defined as systolic blood pressure greater than or equal to 160 mm Hg or diastolic blood pressure greater than or equal to 90 mm Hg * Total cholesterol/HDL cholesterol greater than or equal to 5.0 or LDL cholesterol greater than or equal to 4.21 mmol/L * Peripheral neuropathy severe enough to cause discomfort (for safety reasons) * Overt diabetic nephropathy excluding subjects with a urine albumin to creatinine ratio of greater than 2.0 in men or 2.8 in women * Diabetic retinopathy