Exercise training modalities in patients with type 2 diabetes mellitus: a systematic review and network meta-analysis

International Journal of Behavioral Nutrition and Physical Activity

Long Ge¹  Xue Han¹  Hou-qian Shan¹  Ya-jing Chen¹  Yang-qin Xun¹  Li-qian Zuo¹  Guo-wu Ding¹  Bei Pan¹  Cai-yun Gao¹  Ke-hu Yang²  Jin-hui Tian² 

[1] Department of Social Medicine and Health Management, School of Public Health, Lanzhou University;Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University;

关键词: Type 2 diabetes mellitus;    Exercise training;    Glycemic control;    Cardiovascular risk factors;    Weight loss;    Frequentist network meta-analysis;   

DOI  :  10.1186/s12966-018-0703-3

来源: DOAJ

【 摘 要 】

Abstract Introduction Current international guidelines recommend aerobic, resistance, and combined exercises for the management of type 2 diabetes mellitus (T2DM). In our study, we conducted a network meta-analysis to assess the comparative impact of different exercise training modalities on glycemic control, cardiovascular risk factors, and weight loss in patients with T2DM. Methods We searched five electronic databases to identify randomized controlled trials (RCTs) that compared the differences between different exercise training modalities for patients with T2DM. The risk of bias in the included RCTs was evaluated according to the Cochrane tool. Network meta-analysis was performed to calculate mean difference the ratio of the mean and absolute risk differences. Data were analyzed using R-3.4.0. Results A total of 37 studies with 2208 patients with T2DM were included in our study. Both supervised aerobic and supervised resistance exercises showed a significant reduction in HbA1c compared to no exercise (0.30% lower, 0.30% lower, respectively), however, there was a less reduction when compared to combined exercise (0.17% higher, 0.23% higher). Supervised aerobic also presented more significant improvement than no exercise in fasting plasma glucose (9.38 mg/dl lower), total cholesterol (20.24 mg/dl lower), triacylglycerol (19.34 mg/dl lower), and low-density lipoprotein cholesterol (11.88 mg/dl lower). Supervised resistance showed more benefit than no exercise in improving systolic blood pressure (3.90 mmHg lower]) and total cholesterol (22.08 mg/dl lower]. In addition, supervised aerobic exercise was more powerful in improving HbA1c and weight loss than unsupervised aerobic (HbA1c: 0.60% lower; weight loss: 5.02 kg lower) and unsupervised resistance (HbA1c: 0.53% lower) exercises. Conclusion Compared with either supervised aerobic or supervised resistance exercise alone, combined exercise showed more pronounced improvement in HbA1c levels; however, there was a less marked improvement in some cardiovascular risk factors. In terms of weight loss, there were no significant differences among the combined, supervised aerobic, and supervised resistance exercises. Trial registration Our study protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO); registration number: CRD42017067518.

【 授权许可】

Unknown