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Comparisons of different exercise interventions on glycemic control and insulin resistance in prediabetes: a network meta-analysis.
BMC Endocr Disord. 2021 Sep 06; 21(1):181.BE

Abstract

BACKGROUND

In order to recommend the optimal type of exercise for type 2 diabetes prevention, different exercise interventions were compared with respect to their effects on glycemic control and insulin resistance.

METHODS

Studies on the curative effect of aerobic exercise training (AET), resistance training (RT), or control training (CT) on prediabetes were retrieved from the PubMed, Embase, SPORTDiscus, and Cochrane Library databases. Body mass index (BMI); homeostasis model assessment of insulin resistance index (HOMA-IR); and fasting blood glucose (FBG), glycated hemoglobin (HbA1c), and insulin levels were used as outcome indicators. The Q statistic was calculated to evaluate heterogeneity within studies. A fixed- or random-effects model was used for pooling data based on nonsignificant or significant heterogeneities. A consistency test was conducted using a node-splitting analysis.

RESULTS

A total of 13 eligible studies were included. The results of the direct meta-analysis indicated that AET or RT could significantly reduce the HbA1c level in prediabetic individuals compared to CT [AET vs. CT: standardized mean difference (SMD) = - 0.6739, 95% confidence interval (CI) = - 0.9424 to - 0.4055 to RT vs. CT: SMD = - 1.0014, 95% CI = - 1.3582 to - 0.6446]. The findings from the network meta-analysis showed that there were no statistical differences among the four comparisons for all the indicators except for lower HbA1c level (SMD = - 0.75, 95% CI = - 1.31 to - 0.19) and HOMA-IR (SMD = - 1.03, 95% CI = - 1.96 to - 0.10) in the AET group than in the CT group. In addition, prediabetic individuals in the AET + RT group showed greater control of BMI and insulin and FBG levels than those in the other groups, whereas AET was the most effective in controlling HbA1c and HOMA-IR levels in prediabetic individuals.

CONCLUSION

AET, AET + RT, and RT exerted beneficial effects on insulin resistance and glycemic control in prediabetic patients. From the existing data, AET or AET + RT is preferentially recommended for these patients, although further studies may unveil RT as a promising therapy. Benefits from all types of exercise seem to occur in an intensity-dependent manner.

Authors+Show Affiliations

Institute of Physical Education, Soochow University, Suzhou, 215100, Jiangsu, China.Shanghai Kangjian Foreign Language Experimental Middle School, Xuhui District, Shanghai, 200233, China.Institute of Physical Education, Shanghai Normal University, No. 5, Lane 14, Guilin West Street, Xuhui District, Shanghai, 200234, China. ljtang1976@shnu.edu.cn.

Pub Type(s)

Journal Article
Meta-Analysis

Language

eng

PubMed ID

34488728

Citation

Huang, Li, et al. "Comparisons of Different Exercise Interventions On Glycemic Control and Insulin Resistance in Prediabetes: a Network Meta-analysis." BMC Endocrine Disorders, vol. 21, no. 1, 2021, p. 181.
Huang L, Fang Y, Tang L. Comparisons of different exercise interventions on glycemic control and insulin resistance in prediabetes: a network meta-analysis. BMC Endocr Disord. 2021;21(1):181.
Huang, L., Fang, Y., & Tang, L. (2021). Comparisons of different exercise interventions on glycemic control and insulin resistance in prediabetes: a network meta-analysis. BMC Endocrine Disorders, 21(1), 181. https://doi.org/10.1186/s12902-021-00846-y
Huang L, Fang Y, Tang L. Comparisons of Different Exercise Interventions On Glycemic Control and Insulin Resistance in Prediabetes: a Network Meta-analysis. BMC Endocr Disord. 2021 Sep 6;21(1):181. PubMed PMID: 34488728.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparisons of different exercise interventions on glycemic control and insulin resistance in prediabetes: a network meta-analysis. AU - Huang,Li, AU - Fang,Yingjie, AU - Tang,Lijun, Y1 - 2021/09/06/ PY - 2020/06/08/received PY - 2021/08/23/accepted PY - 2021/9/7/entrez PY - 2021/9/8/pubmed PY - 2022/1/18/medline KW - Aerobic exercise training KW - Glycemic control KW - Insulin resistance KW - Network meta-analysis KW - Prediabetes KW - Resistance training SP - 181 EP - 181 JF - BMC endocrine disorders JO - BMC Endocr Disord VL - 21 IS - 1 N2 - BACKGROUND: In order to recommend the optimal type of exercise for type 2 diabetes prevention, different exercise interventions were compared with respect to their effects on glycemic control and insulin resistance. METHODS: Studies on the curative effect of aerobic exercise training (AET), resistance training (RT), or control training (CT) on prediabetes were retrieved from the PubMed, Embase, SPORTDiscus, and Cochrane Library databases. Body mass index (BMI); homeostasis model assessment of insulin resistance index (HOMA-IR); and fasting blood glucose (FBG), glycated hemoglobin (HbA1c), and insulin levels were used as outcome indicators. The Q statistic was calculated to evaluate heterogeneity within studies. A fixed- or random-effects model was used for pooling data based on nonsignificant or significant heterogeneities. A consistency test was conducted using a node-splitting analysis. RESULTS: A total of 13 eligible studies were included. The results of the direct meta-analysis indicated that AET or RT could significantly reduce the HbA1c level in prediabetic individuals compared to CT [AET vs. CT: standardized mean difference (SMD) = - 0.6739, 95% confidence interval (CI) = - 0.9424 to - 0.4055 to RT vs. CT: SMD = - 1.0014, 95% CI = - 1.3582 to - 0.6446]. The findings from the network meta-analysis showed that there were no statistical differences among the four comparisons for all the indicators except for lower HbA1c level (SMD = - 0.75, 95% CI = - 1.31 to - 0.19) and HOMA-IR (SMD = - 1.03, 95% CI = - 1.96 to - 0.10) in the AET group than in the CT group. In addition, prediabetic individuals in the AET + RT group showed greater control of BMI and insulin and FBG levels than those in the other groups, whereas AET was the most effective in controlling HbA1c and HOMA-IR levels in prediabetic individuals. CONCLUSION: AET, AET + RT, and RT exerted beneficial effects on insulin resistance and glycemic control in prediabetic patients. From the existing data, AET or AET + RT is preferentially recommended for these patients, although further studies may unveil RT as a promising therapy. Benefits from all types of exercise seem to occur in an intensity-dependent manner. SN - 1472-6823 UR - https://www.unboundmedicine.com/medline/citation/34488728/Comparisons_of_different_exercise_interventions_on_glycemic_control_and_insulin_resistance_in_prediabetes:_a_network_meta_analysis_ DB - PRIME DP - Unbound Medicine ER -