Exercise modalities for type 2 diabetes: A systematic review and network meta-analysis of randomized trials
作者地址
Lanzhou Univ, Evidence Based Med Ctr, Sch Basic Med Sci, Lanzhou, Peoples R China
;
Key Lab Evidence Based Med & Knowledge Translat Ga, Lanzhou, Peoples R China
来源期刊
DIABETES-METABOLISM RESEARCH AND REVIEWS
摘要
AimsWe aimed to determine the effects of different exercise modalities in patients with type 2 diabetes mellitus (T2DM). MethodsWe searched PubMed, Embase, and the Cochrane Library from their inception until July 2020 to identify randomised controlled trials (RCTs) on exercise in adults with T2DM. Paired reviewers independently performed study selection, data extraction, and risk of bias assessment. The certainty of the evidence was assessed using the Confidence in Network Meta-Analysis (CINeMA) framework. ResultsA total of 106 RCTs that enroled eight exercise modalities with 7438 patients were included. Six exercise modalities, except unsupervised aerobic/resistance exercise, significantly reduced glycosylated haemoglobin (HbA1c), with mean differences (MDs) ranging from 0.71 (95% confidence interval [CI]: 0.34-1.08) to 0.34 (95% CI: 0.17-0.52), low to high certainty, in comparison with no exercise. The evidence of low to moderate certainty showed that supervised aerobic/resistance exercise improved glycaemic control, body weight, blood pressure, and blood lipid profiles compared with no exercise. Flexibility exercise may be associated with glycaemic control (HbA1c: MD = 0.71, 95% CI: 0.34-1.08); fasting plasma glucose (MD = 1.48, 95% CI: 0.78-2.17), and weight loss (MD = 1.80, 95% CI: 0.85-2.75) compared with controls, but not blood pressure and lipid profiles. Balance exercise showed the largest benefit in improving total cholesterol (MD = 52.81, 95% CI: 28.47-77.16) and low certainty. We found no significant differences between exercises and the triacylglycerol (TG) level. ConclusionsOverall, our network meta-analyses support the recommendation for exercise in patients with T2DM, especially supervised exercises. Limited evidence supports the benefits of flexibility and balance exercises. The effectiveness of exercise modalities for TG reduction remains unclear.
资助信息
the Fundamental Research Funds for the Central Universities (18LZUJBWZX006, 2019JBKYJC002);Evidence-based sociology research, China Medical Board Open Project Funding (CMB 17-279);Tracking and Evaluating Quality (TEQ) of Rural Health Services in NW China;ool kits for rural clinic quality management, capacity building, and Special Fund for Soft Science in Gansu Province (18CX1ZA043);
资助机构
科研处
;
中国医学委员会
;
甘肃省科技厅
WOS学科分类
Endocrinology & Metabolism
WOS关键词
GLYCEMIC CONTROLRESISTANCE-EXERCISEAEROBIC EXERCISEMELLITUSYOGAIMPACTINCONSISTENCYASSOCIATIONCONSISTENCYSTATEMENT
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