Physical Activity Advice Only or Structured Exercise Training and Association With HbA1c Levels in Type 2 Diabetes: A Systematic Review and Meta-analysis
Daniel Umpierre,Paula A.B. Ribeiro,Caroline K. Kramer,Cristiane Bauermann Leitão,Alessandra T. N. Zucatti,Mirela Jobim de Azevedo,Jorge Luiz Gross,Jorge Pinto Ribeiro,Beatriz D'Agord Schaan +8 more
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Structured exercise training that consists of aerobic exercise, resistance training, or both combined is associated with HbA(1c) reduction in patients with type 2 diabetes.Abstract:
Context Regular exercise improves glucose control in diabetes, but the association of different exercise training interventions on glucose control is unclear. Objective To conduct a systematic review and meta-analysis of randomized controlled clinical trials (RCTs) assessing associations of structured exercise training regimens (aerobic, resistance, or both) and physical activity advice with or without dietary cointervention on change in hemoglobin A1c (HbA1c) in type 2 diabetes patients. Data Sources MEDLINE, Cochrane-CENTRAL, EMBASE, ClinicalTrials.gov, LILACS, and SPORTDiscus databases were searched from January 1980 through February 2011. Study Selection RCTs of at least 12 weeks' duration that evaluated the ability of structured exercise training or physical activity advice to lower HbA1c levels as compared with a control group in patients with type 2 diabetes. Data Extraction Two independent reviewers extracted data and assessed quality of the included studies. Data Synthesis Of 4191 articles retrieved, 47 RCTs (8538 patients) were included. Pooled mean differences in HbA1c levels between intervention and control groups were calculated using a random-effects model. Overall, structured exercise training (23 studies) was associated with a decline in HbA1c level (−0.67%; 95% confidence interval [CI], −0.84% to −0.49%; I2, 91.3%) compared with control participants. In addition, structured aerobic exercise (−0.73%; 95% CI, −1.06% to −0.40%; I2, 92.8%), structured resistance training (−0.57%; 95% CI, −1.14% to −0.01%; I2, 92.5%), and both combined (−0.51%; 95% CI, −0.79% to −0.23%; I2, 67.5%) were each associated with declines in HbA1C levels compared with control participants. Structured exercise durations of more than 150 minutes per week were associated with HbA1c reductions of 0.89%, while structured exercise durations of 150 minutes or less per week were associated with HbA1C reductions of 0.36%. Overall, interventions of physical activity advice (24 studies) were associated with lower HbA1c levels (−0.43%; 95% CI, −0.59% to −0.28%; I2, 62.9%) compared with control participants. Combined physical activity advice and dietary advice was associated with decreased HbA1c (−0.58%; 95% CI, −0.74% to −0.43%; I2, 57.5%) as compared with control participants. Physical activity advice alone was not associated with HbA1c changes. Conclusions Structured exercise training that consists of aerobic exercise, resistance training, or both combined is associated with HbA1c reduction in patients with type 2 diabetes. Structured exercise training of more than 150 minutes per week is associated with greater HbA1c declines than that of 150 minutes or less per week. Physical activity advice is associated with lower HbA1c, but only when combined with dietary advice.read more
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Exercise Standards for Testing and Training A Scientific Statement From the American Heart Association
Gerald F. Fletcher,Philip A. Ades,Paul Kligfield,Ross Arena,Gary J. Balady,Vera Bittner,Lola A. Coke,Jerome L. Fleg,Daniel E. Forman,Thomas C. Gerber,Martha Gulati,Kushal Madan,Jonathan Rhodes,Paul D. Thompson,Mark A. Williams +14 more
TL;DR: These guidelines are a revision of the 1995 standards of the AHA that addressed the issues of exercise testing and training and current issues of practical importance in the clinical use of these standards are considered.
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2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD
Francesco Cosentino,Peter J. Grant,Victor Aboyans,Clifford J Bailey,Antonio Ceriello,Victoria Delgado,Massimo Federici,Gerasimos Filippatos,Diederick E. Grobbee,Tina Birgitte Hansen,Heikki V. Huikuri,I. Johansson,Peter Jüni,Maddalena Lettino,Nikolaus Marx,Linda Mellbin,Carl J. Östgren,Bianca Rocca,Marco Roffi,Naveed Sattar,Petar M. Seferović,Miguel Sousa-Uva,Paul Valensi,David C Wheeler +23 more
TL;DR: The second iteration of the European Society of Cardiology (ESC) and European Association for the Study of Diabetes (EASD) joining forces to write guidelines on the management of diabetes mellitus (DM), pre-diabetes, and cardiovascular disease (CVD), designed to assist clinicians and other healthcare workers to make evidence-based management decisions.
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Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes Association
Sheri R. Colberg,Ronald J. Sigal,Jane E. Yardley,Michael C. Riddell,David W. Dunstan,Paddy C. Dempsey,Edward S. Horton,Kristin Castorino,Deborah F. Tate +8 more
TL;DR: A clinically oriented review and evidence-based recommendations regarding physical activity and exercise in people with type 1 diabetes, type 2 diabetes, gestational diabetes mellitus, and prediabetes are provided.
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ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD: the Task Force on diabetes, pre-diabetes, and cardiovascular diseases of the European Society of Cardiology (ESC) and developed in collaboration with the European Association for the Study of Diabetes (EASD)
References
More filters
Journal Article
Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement.
TL;DR: The QUOROM Statement (QUality Of Reporting Of Meta-analyses) as mentioned in this paper was developed to address the suboptimal reporting of systematic reviews and meta-analysis of randomized controlled trials.
Journal ArticleDOI
Measuring inconsistency in meta-analyses
TL;DR: A new quantity is developed, I 2, which the authors believe gives a better measure of the consistency between trials in a meta-analysis, which is susceptible to the number of trials included in the meta- analysis.
Journal ArticleDOI
The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and Elaboration
Alessandro Liberati,Douglas G. Altman,Jennifer Tetzlaff,Cynthia D. Mulrow,Peter C Gøtzsche,John P. A. Ioannidis,Mike Clarke,Mike Clarke,Philip J. Devereaux,Jos Kleijnen,David Moher +10 more
TL;DR: An Explanation and Elaboration of the PRISMA Statement is presented and updated guidelines for the reporting of systematic reviews and meta-analyses are presented.
Journal ArticleDOI
Trim and fill: A simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis.
Sue Duval,Richard L. Tweedie +1 more
TL;DR: In this paper, a rank-based data augmentation technique is proposed for estimating the number of missing studies that might exist in a meta-analysis and the effect that these studies might have had on its outcome.