Effects of Lifestyle Interventions to Promote Physical Activity on Physical Activity and Glycated Hemoglobin in Patients with Type 2 Diabetes: a Systematic Review and Meta-Analysis

IF 9.3 1区医学 Q1 SPORT SCIENCES Sports Medicine Pub Date : 2025-03-13 DOI:10.1007/s40279-025-02184-8

Vivien Hohberg, Eric Lichtenstein, Jan-Niklas Kreppke, Cedrine Zanitti, Fiona Streckmann, Markus Gerber, Oliver Faude

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Abstract

Background

Numerous studies have explored the impact of controlled exercise interventions in type 2 diabetes, as physical activity can positively influence its progression. However, our understanding of how broader lifestyle interventions can effectively promote physical activity in practical real-world scenarios remains limited.

Objective

This systematic review and meta-analysis aimed to investigate the potential of lifestyle interventions targeting the promotion of physical activity on physical activity outcomes and glycated hemoglobin (HbA1c), providing a comprehensive understanding of both behavioral and clinical impacts.

Methods

We performed a systematic review and meta-analysis, searching three databases and examined the study design, structure, and content of the lifestyle interventions. We assessed physical activity and HbA1c as endpoints and performed a multivariate meta-regression to explore physical activity’s impact on HbA1c.

Results

This review incorporated 13 studies (n = 5301 patients), with heterogeneity in intervention designs, components, and durations. Lifestyle interventions showed a slight increase in physical activity, equivalent to an average of 9.0 min more total physical activity per day (95% confidence interval 5.8, 12.2) and 1.7 min more moderate-to-vigorous physical activity per day (95% confidence interval 1.1, 2.3), irrespective of objective (e.g., accelerometers) or subjective measurement (e.g., questionnaires) method. However, HbA1c reduction through these interventions was minimal 0.09% (95% confidence interval − 0.20, 0.03). The effect of physical activity was − 0.04 (standard error = 0.05, 95% confidence interval − 0.15, 0.06), suggesting that physical activity does not act as a moderator for changes in HbA1c.

Conclusions

Lifestyle interventions effectively increase physical activity but have limited impact on HbA1c compared to controls. The role of physical activity as a moderator for changes in HbA1c remains uncertain. Further research is needed to enhance the efficacy of these interventions in reducing HbA1c in individuals with type 2 diabetes.

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背景大量研究探讨了控制性运动干预对 2 型糖尿病的影响，因为体育锻炼可对糖尿病的进展产生积极影响。本系统综述和荟萃分析旨在研究以促进体力活动为目标的生活方式干预对体力活动结果和糖化血红蛋白（HbA1c）的潜在影响，从而全面了解行为和临床影响。方法我们进行了系统综述和荟萃分析，搜索了三个数据库，并检查了生活方式干预的研究设计、结构和内容。我们将体力活动和 HbA1c 作为终点进行了评估，并进行了多元荟萃回归以探讨体力活动对 HbA1c 的影响。结果该综述纳入了 13 项研究（n = 5301 名患者），干预设计、内容和持续时间均存在异质性。生活方式干预显示体力活动略有增加，相当于每天总体力活动平均增加 9.0 分钟（95% 置信区间为 5.8 - 12.2），每天中强度体力活动平均增加 1.7 分钟（95% 置信区间为 1.1 - 2.3），无论采用客观测量（如加速度计）还是主观测量（如问卷调查）方法。然而，通过这些干预措施降低的 HbA1c 值仅为 0.09%（95% 置信区间-0.20，0.03）。体育锻炼的效果为-0.04（标准误差 = 0.05，95% 置信区间 - 0.15，0.06），这表明体育锻炼对 HbA1c 的变化不起调节作用。体育锻炼对 HbA1c 变化的调节作用仍不确定。要提高这些干预措施在降低 2 型糖尿病患者 HbA1c 方面的效果，还需要进一步的研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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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.