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Volume of supervised exercise training impacts glycaemic control in patients with type 2 diabetes: a systematic review with meta-regression analysis.

Abstract

AIMS/HYPOTHESIS

Supervised exercise programmes improve glycaemic control in type 2 diabetes, but training characteristics associated with reduction in HbA(1c) remain unclear. We conducted a systematic review with meta-regression analysis of randomised clinical trials (RCTs) assessing the association between intensity and volume of exercise training (aerobic, resistance or combined) and HbA(1c) changes in patients with type 2 diabetes.

METHODS

Five electronic databases were searched (1980-2012) to retrieve RCTs of at least 12 weeks' duration, consisting of supervised exercise training vs no intervention, that reported HbA(1c) changes and exercise characteristics. Two independent reviewers conducted study selection and data extraction.

RESULTS

Twenty-six RCTs (2,253 patients) met the inclusion criteria. In multivariate analysis, baseline HbA(1c) and exercise frequency explained nearly 58% of between-study variance. Baseline HbA(1c) was inversely correlated with HbA(1c) reductions after the three types of exercise training. In aerobic training, exercise volume (represented by frequency of sessions) was associated with changes in HbA(1c) (weighted r = -0.64), while no variables were correlated with glycaemic control induced by resistance training. In combined training, weekly volume of resistance exercise explained heterogeneity in multivariate analysis and was associated with changes in HbA(1c) levels (weighted r = -0.70).

CONCLUSIONS/INTERPRETATION

Reduction in HbA(1c) is associated with exercise frequency in supervised aerobic training, and with weekly volume of resistance exercise in supervised combined training. Therefore, exercise volume is a major determinant of glycaemic control in patients with type 2 diabetes.

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  • Authors+Show Affiliations

    ,

    Exercise Pathophysiology Research Laboratory, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, Centro de Pesquisa Clínica-LaFiex, Porto Alegre, RS, Brazil. daniel.umpierre@gmail.com

    , ,

    Source

    Diabetologia 56:2 2013 Feb pg 242-51

    MeSH

    Blood Glucose
    Diabetes Mellitus, Type 2
    Exercise
    Humans

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Research Support, Non-U.S. Gov't
    Review
    Systematic Review

    Language

    eng

    PubMed ID

    23160642

    Citation

    Umpierre, D, et al. "Volume of Supervised Exercise Training Impacts Glycaemic Control in Patients With Type 2 Diabetes: a Systematic Review With Meta-regression Analysis." Diabetologia, vol. 56, no. 2, 2013, pp. 242-51.
    Umpierre D, Ribeiro PA, Schaan BD, et al. Volume of supervised exercise training impacts glycaemic control in patients with type 2 diabetes: a systematic review with meta-regression analysis. Diabetologia. 2013;56(2):242-51.
    Umpierre, D., Ribeiro, P. A., Schaan, B. D., & Ribeiro, J. P. (2013). Volume of supervised exercise training impacts glycaemic control in patients with type 2 diabetes: a systematic review with meta-regression analysis. Diabetologia, 56(2), pp. 242-51. doi:10.1007/s00125-012-2774-z.
    Umpierre D, et al. Volume of Supervised Exercise Training Impacts Glycaemic Control in Patients With Type 2 Diabetes: a Systematic Review With Meta-regression Analysis. Diabetologia. 2013;56(2):242-51. PubMed PMID: 23160642.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Volume of supervised exercise training impacts glycaemic control in patients with type 2 diabetes: a systematic review with meta-regression analysis. AU - Umpierre,D, AU - Ribeiro,P A B, AU - Schaan,B D, AU - Ribeiro,J P, Y1 - 2012/11/16/ PY - 2012/05/03/received PY - 2012/08/29/accepted PY - 2012/11/20/entrez PY - 2012/11/20/pubmed PY - 2013/6/13/medline SP - 242 EP - 51 JF - Diabetologia JO - Diabetologia VL - 56 IS - 2 N2 - AIMS/HYPOTHESIS: Supervised exercise programmes improve glycaemic control in type 2 diabetes, but training characteristics associated with reduction in HbA(1c) remain unclear. We conducted a systematic review with meta-regression analysis of randomised clinical trials (RCTs) assessing the association between intensity and volume of exercise training (aerobic, resistance or combined) and HbA(1c) changes in patients with type 2 diabetes. METHODS: Five electronic databases were searched (1980-2012) to retrieve RCTs of at least 12 weeks' duration, consisting of supervised exercise training vs no intervention, that reported HbA(1c) changes and exercise characteristics. Two independent reviewers conducted study selection and data extraction. RESULTS: Twenty-six RCTs (2,253 patients) met the inclusion criteria. In multivariate analysis, baseline HbA(1c) and exercise frequency explained nearly 58% of between-study variance. Baseline HbA(1c) was inversely correlated with HbA(1c) reductions after the three types of exercise training. In aerobic training, exercise volume (represented by frequency of sessions) was associated with changes in HbA(1c) (weighted r = -0.64), while no variables were correlated with glycaemic control induced by resistance training. In combined training, weekly volume of resistance exercise explained heterogeneity in multivariate analysis and was associated with changes in HbA(1c) levels (weighted r = -0.70). CONCLUSIONS/INTERPRETATION: Reduction in HbA(1c) is associated with exercise frequency in supervised aerobic training, and with weekly volume of resistance exercise in supervised combined training. Therefore, exercise volume is a major determinant of glycaemic control in patients with type 2 diabetes. SN - 1432-0428 UR - https://www.unboundmedicine.com/medline/citation/23160642/Volume_of_supervised_exercise_training_impacts_glycaemic_control_in_patients_with_type_2_diabetes:_a_systematic_review_with_meta_regression_analysis_ L2 - https://dx.doi.org/10.1007/s00125-012-2774-z DB - PRIME DP - Unbound Medicine ER -