The Best Exercise Modality and Dose to Reduce Glycosylated Hemoglobin in Patients with Type 2 Diabetes: A Systematic Review with Pairwise, Network, and Dose-Response Meta-Analyses.

IF 9.3 1区医学 Q1 SPORT SCIENCES Sports Medicine Pub Date : 2024-10-01 Epub Date: 2024-06-25 DOI:10.1007/s40279-024-02057-6

Zhide Liang, Meng Zhang, Chuanzhi Wang, Fengwei Hao, Yingdanni Yu, Shudong Tian, Yang Yuan

{"title":"The Best Exercise Modality and Dose to Reduce Glycosylated Hemoglobin in Patients with Type 2 Diabetes: A Systematic Review with Pairwise, Network, and Dose-Response Meta-Analyses.","authors":"Zhide Liang, Meng Zhang, Chuanzhi Wang, Fengwei Hao, Yingdanni Yu, Shudong Tian, Yang Yuan","doi":"10.1007/s40279-024-02057-6","DOIUrl":null,"url":null,"abstract":"Background: Persistently elevated glycosylated hemoglobin (HbA1c) is associated with a higher risk of long-term vascular complications.Objective: We evaluated the effect of different exercise modalities and doses on HbA1c levels in patients with type 2 diabetes.Methods: A systematic search for randomized controlled trials involving exercise interventions in patients with type 2 diabetes was conducted across seven electronic databases, encompassing data from their inception up to October 2023. Two independent reviewers assessed the quality of the literature. Pairwise, network, and dose-response meta-analyses using the random-effects model were conducted to analyze the effect of exercise on HbA1c levels.Results: A total of 85 randomized controlled trials with 5535 participants were included. The network meta-analysis showed that high-intensity interval training (HIIT) has the highest ranked (MD = - 0.78% [- 8.50 mmol/mol]; 95% CrI: - 1.04, - 0.51), followed by combined aerobic and resistance exercise (CE) (MD = - 0.54% [- 5.90 mmol/mol]; 95% CrI: - 0.69, - 0.40), yoga (MD = - 0.45% [- 4.92 mmol/mol]; 95% CrI: - 0.77, - 0.13), and continuous aerobic exercise (CAE) (MD = - 0.42% [- 4.58 mmol/mol]; 95% CrI: - 0.54, - 0.30). In addition, a significant improvement in HbA1c levels can be observed when the total exercise dose reaches 840 metabolic equivalent of tasks-min/week.Conclusions: There was low-quality evidence that HIIT, CE, yoga, and CAE may be effective treatment modalities for improving HbA1c in patients with type 2 diabetes, and there was no significant difference in efficacy. Moreover, a non-linear dose-response relationship was found for total exercise and HbA1c levels. Future research should further investigate the specific effects of different exercise doses on HbA1c levels in patients with type 2 diabetes and provide a more personalized exercise prescription.","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":" ","pages":"2557-2570"},"PeriodicalIF":9.3000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Sports Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s40279-024-02057-6","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/6/25 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"SPORT SCIENCES","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Persistently elevated glycosylated hemoglobin (HbA1c) is associated with a higher risk of long-term vascular complications.

Objective: We evaluated the effect of different exercise modalities and doses on HbA1c levels in patients with type 2 diabetes.

Methods: A systematic search for randomized controlled trials involving exercise interventions in patients with type 2 diabetes was conducted across seven electronic databases, encompassing data from their inception up to October 2023. Two independent reviewers assessed the quality of the literature. Pairwise, network, and dose-response meta-analyses using the random-effects model were conducted to analyze the effect of exercise on HbA1c levels.

Results: A total of 85 randomized controlled trials with 5535 participants were included. The network meta-analysis showed that high-intensity interval training (HIIT) has the highest ranked (MD = - 0.78% [- 8.50 mmol/mol]; 95% CrI: - 1.04, - 0.51), followed by combined aerobic and resistance exercise (CE) (MD = - 0.54% [- 5.90 mmol/mol]; 95% CrI: - 0.69, - 0.40), yoga (MD = - 0.45% [- 4.92 mmol/mol]; 95% CrI: - 0.77, - 0.13), and continuous aerobic exercise (CAE) (MD = - 0.42% [- 4.58 mmol/mol]; 95% CrI: - 0.54, - 0.30). In addition, a significant improvement in HbA1c levels can be observed when the total exercise dose reaches 840 metabolic equivalent of tasks-min/week.

Conclusions: There was low-quality evidence that HIIT, CE, yoga, and CAE may be effective treatment modalities for improving HbA1c in patients with type 2 diabetes, and there was no significant difference in efficacy. Moreover, a non-linear dose-response relationship was found for total exercise and HbA1c levels. Future research should further investigate the specific effects of different exercise doses on HbA1c levels in patients with type 2 diabetes and provide a more personalized exercise prescription.

Abstract Image

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

降低 2 型糖尿病患者糖化血红蛋白的最佳运动方式和剂量：配对分析、网络分析和剂量反应元分析的系统回顾

背景：持续升高的糖化血红蛋白（HbA1c）与长期血管并发症的风险有关：持续升高的糖化血红蛋白（HbA1c）与较高的长期血管并发症风险相关：我们评估了不同运动方式和剂量对 2 型糖尿病患者 HbA1c 水平的影响：我们在 7 个电子数据库中对涉及 2 型糖尿病患者运动干预的随机对照试验进行了系统检索，涵盖了从试验开始到 2023 年 10 月的数据。两位独立审稿人对文献质量进行了评估。采用随机效应模型进行配对分析、网络分析和剂量反应荟萃分析，分析运动对HbA1c水平的影响：结果：共纳入了 85 项随机对照试验，5535 名参与者。网络荟萃分析显示，高强度间歇训练（HIIT）的排名最高（MD = - 0.78% [- 8.50 mmol/mol]；95% CrI：- 1.04，- 0.51），其次是有氧和阻力联合运动（CE）（MD = - 0.54% [- 5.90 mmol/mol]；95% CrI：- 0.69，- 0.40）、瑜伽（MD = - 0.45% [- 4.92 mmol/mol]；95% CrI：- 0.77，- 0.13）和持续有氧运动（CAE）（MD = - 0.42% [- 4.58 mmol/mol]；95% CrI：- 0.54，- 0.30）。此外，当总运动量达到 840 个代谢当量任务-分钟/周时，可观察到 HbA1c 水平有明显改善：低质量证据表明，HIIT、CE、瑜伽和CAE可能是改善2型糖尿病患者HbA1c的有效治疗方式，且疗效无明显差异。此外，研究还发现总运动量与 HbA1c 水平之间存在非线性剂量-反应关系。未来的研究应进一步探讨不同运动剂量对2型糖尿病患者HbA1c水平的具体影响，并提供更加个性化的运动处方。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Sports Medicine 医学-运动科学

CiteScore

18.40

自引率

5.10%

发文量

165

审稿时长

6-12 weeks

期刊介绍： Sports Medicine focuses on providing definitive and comprehensive review articles that interpret and evaluate current literature, aiming to offer insights into research findings in the sports medicine and exercise field. The journal covers major topics such as sports medicine and sports science, medical syndromes associated with sport and exercise, clinical medicine's role in injury prevention and treatment, exercise for rehabilitation and health, and the application of physiological and biomechanical principles to specific sports. Types of Articles: Review Articles: Definitive and comprehensive reviews that interpret and evaluate current literature to provide rationale for and application of research findings. Leading/Current Opinion Articles: Overviews of contentious or emerging issues in the field. Original Research Articles: High-quality research articles. Enhanced Features: Additional features like slide sets, videos, and animations aimed at increasing the visibility, readership, and educational value of the journal's content. Plain Language Summaries: Summaries accompanying articles to assist readers in understanding important medical advances. Peer Review Process: All manuscripts undergo peer review by international experts to ensure quality and rigor. The journal also welcomes Letters to the Editor, which will be considered for publication.