Effect of Pilates on Body Composition and Some Biochemical Parameters of Women with Type 2 Diabetes on a Low-Carbohydrate or High-Complex-Carbohydrate Diabetic Diet

Abstract

Background: The prevalence of type 2 diabetes mellitus (T2DM) has increased dramatically in the past 30 years. The World Health Organization has prepared an action plan to stop the increase in diabetes and obesity by 2025. Objectives: This study was conducted to assess the effect of pilates on body composition and some biochemical parameters in women with T2DM on a high-complex-carbohydrate diabetic diet or a low-carbohydrate/high-monounsaturated fatty acids (MUFA) diet. Methods: This experimental study was conducted on 120 woman patients with T2DM, referring to the Fatih Medical Park Hospital’s Internal Medicine Department, Istanbul, Turkey, between December 2018 and June 2019. Participants were divided into 4 groups and were followed up for 12 weeks. The mean participants’ age was 41.67 ± 3.83 years. The first group received a low-carbohydrate and high MUFA (LC, MUFA) diet, the second group received a low-carbohydrate and a high-MUFA diet and did pilates (LC, MUFA + PL), the third group received a higher complex carbohydrate (HCC) diet, and the fourth group took the HCC diet and did pilates (HCC + PL). Results: According to the applied intervention method, there were significant differences between the preliminary and final measurements of body mass index, body fat percentage, muscle mass, and fasting blood glucose, insulin, HbA1c, total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglyceride (TG) values (P < 0.05). In this study, only an increase in body muscle composition of the women in the LC, MUFA + PL group was found significant (P < 0.05). The highest decrease in body fat ratio was determined again in the LC, MUFA + PL group (P < 0.05). HDL levels of the women who did pilates increased significantly than other groups (P < 0.05). Conclusions: In the treatment of diabetes, the patient should be evaluated with a multidisciplinary team. Diet and exercise are important non-pharmacological interventions in the treatment of diabetes.

Effect of Pilates on Glucose and Lipids: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…The risk-of-bias assessment is shown in Figure 2 . All studies were described as randomly generated, while only five of them (Ramezankhany et al, 2011 ; Marinda et al, 2013 ; Zhang and Chen, 2019 ; Batar et al, 2020 ; Cui et al, 2020 ) recorded the methods of randomization in detail. Blinding was described in one study (Jung et al, 2020 ).…”

“…Diabetic patients from the three studies (Zolfaghari et al, 2015 ; Khormizi and Azarniveh, 2017 ; Zhang and Chen, 2019 ) receiving 8-week interventions, and the HbA1c was pronouncedly higher in the PG than that in the CG after intervention (MD = −0.96%, 95% CI: [−1.06, −0.86]%, P < 0.0001, I 2 = 0%). Six studies (Tunar et al, 2012 ; Yucel and Uysal, 2018 ; Abd EL-Monim et al, 2019 ; Batar et al, 2020 ; Cui et al, 2020 ; Melo et al, 2020 ) reported a 12-week intervention, and we found that diabetes patients receiving 12 weeks of Pilates training showed a greater reduction in HbA1c than those with control conditions (MD = −0.59%, 95% CI: [−1.29, −0.11]%, P = 0.10, I 2 = 92%) ( Supplementary Figure 6 ).…”

“…Overall, a significant effect was determined (MD = −12.59 mg/dL, 95% CI: [−19.88, −5.29] mg/dL, P = 0.0007, I 2 = 86%). Subgroup analyses by population group demonstrated that there was a significant difference between the PG and CG for subjects with diabetes (MD = −15.82 mg/dL, 95% CI: [−24.46, −7.18] mg/dL, P = 0.0003, I 2 = 92%), and the effect sizes of 8 and 12-week interventions were pooled from one study (Zhang and Chen, 2019 ) (MD = −76.20 mg/dL, 95% CI: [−98.68, −53.72] mg/dL, P < 0.0001, I 2 was not applicable) and three studies (Tunar et al, 2012 ; Abd EL-Monim et al, 2019 ; Batar et al, 2020 ) (MD = −5.53 mg/dL, 95% CI: [−14.71, 4.01] mg/dL, P = 0.26, I 2 = 73%) respectively, while both groups showed a similar effect for non-diabetic persons (MD = −4.57 mg/dL, 95% CI: [−18.18, 9.04] mg/dL, P = 0.51, I 2 = 0%) ( Figure 8 ).…”

“…From 10 (Ramezankhany et al, 2011 ; Tunar et al, 2012 ; Marinda et al, 2013 ; Khormizi and Azarniveh, 2017 ; Yucel and Uysal, 2018 ; Abd EL-Monim et al, 2019 ; Aslan et al, 2019 ; Batar et al, 2020 ; Jung et al, 2020 ; Melo et al, 2020 ) of the 15 included studies, patients received Pilates training from 120 min/w to 180 min/w; there were 3 other studies (Zolfaghari et al, 2015 ; Zhang and Chen, 2019 ; Cui et al, 2020 ) reporting Pilates exercise intensity more than 200 min/w. We found that when diabetic patients received Pilates more than 200 min/w, they had a greater improvement in fasting blood glucose (MD = −20.59 mg/dL, 95% CI: [−38.88, −2.30] mg/dL, P = 0.03, I 2 = 95%), and post-prandial blood glucose (MD = −23.22 mg/dL, 95% CI: [−29.52, −16.93] mg/dL, P < 0.0001, I 2 = 0%) compared to patients on the waiting list.…”

“…All the articles were imported into EndNote X8 (Bld, 10063) to remove duplicates. After removing 834 duplicates and eliminating 3,819 articles through screening their titles and abstracts, 15 RCTs (Ramezankhany et al, 2011;Tunar et al, 2012;Marinda et al, 2013;Zolfaghari et al, 2015;Gokgul and Hazar, 2017;Khormizi and Azarniveh, 2017;Yucel and Uysal, 2018;Abd EL-Monim et al, 2019;Aslan et al, 2019;Kumar, 2019;Zhang and Chen, 2019;Batar et al, 2020;Cui et al, 2020;Jung et al, 2020;Melo et al, 2020) comprising 587 participants were reviewed (Figure 1). Thirteen studies were excluded: three without full-text and five non-RCTs (as listed in Supplementary Figure 2).…”