Diabetic Foot Exercises Using Marbles on Blood Sugar Levels: A Quasi Experimental Study
Keywords:
Diabetic Foot Exercises, Marbles, Blood Sugar Levels, Type 2 Diabetes Mellitus, Non-Pharmacological InterventionAbstract
OBJECTIVE: To investigate the impact of diabetic foot exercises with marbles on blood sugar in type 2 diabetes (DM) individuals.
METHODOLOGY: A quasi-experimental pretest-posttest control-group design was used at the Diabetes Centre of Manado City. This study was conducted from August 2025 to February 2026. A total of 178 participants were randomly assigned to the intervention group (n=89), who practiced marble-based foot exercises, and the control group (n=89), who performed regular foot exercises for 12 sessions over four weeks. Data analized using paired t-tests and independent t-tests for bivariate comparisons, multiple linear regression (backward elimination) to identify predictors of RBS reduction, and binary logistic regression to estimate the probability of clinically meaningful RBS decline (?30 mg/dL) (?=0.05).
RESULTS: Both groups showed significant reductions in blood sugar levels (p<0.001). Compared with the control group, the intervention group showed larger reductions in RBS (?=48.86 vs 21.22 mg/dL) and FBS (?=29.78 vs 12.62 mg/dL), with large effects (Cohen's d=1.14 and 1.04, respectively). The marble intervention was the strongest predictor (? = 0.469; OR = 5.376; p < 0.001), followed by baseline RBS, BMI, and DM duration. The marble intervention was the strongest predictor (? = 0.469; OR = 5.376, p < 0.001).
CONCLUSION: Diabetic foot exercises using marbles significantly reduced RBS and FBS levels more than regular foot exercises (p < 0.001; Cohen's d > 0.8). Intervention type, baseline RBS, BMI, and DM duration were significant predictors, yet the model explained only 43.3% of the variance, indicating the need for further investigation.
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