In order to assess the effects of regular walking on metabolic control and cardiovascular risk factors in type 2 diabetes 26 patients from one primary care clinic, aged 60.0 +/- 7.3 years, participated in a walking program during 4 months. Prescribed exercise was walking for 45-60 min three times weekly. A control group of 26 patients from a neighboring primary care clinic, aged 59.3 +/- 6.2 years, received no exercise instructions. Thus, randomization was not performed. There were no improvements of blood pressure, body mass index, physical fitness, glycated hemoglobin A I c, fasting plasma glucose or insulin by intention-to-treat analysis. Seventeen patients in the intervention group increased their physical activity and improved systolic blood pressure; -7.6 mmHg (-15 to -0.2), diastolic blood pressure; -4.3 mmHg (-7.4 to -1.2), body mass index; -0.6 kg/m(2) (-1.1 to -0.1) and total plasma cholesterol; -0.6 mmol/l (-0.9 to -0.3), (mean difference, with 95% CI). We could observe no effects on glucose metabolism in either group. Our results suggest that an increase of regular physical activity equivalent to 45 min of walking 3 days/week may suffice to improve systolic and diastolic blood pressure, lipid metabolism and BMI in patients with type 2 diabetes. (c) 2005 Elsevier Ireland Ltd. All rights reserved.