Effects of exercise training parameters on cardiorespiratory fitness of individuals with type 2 diabetes mellitus: a systematic review and meta-analysis

Cândido, Gabriela do Nascimento; Batalha, Ana Paula; Chaves, Gabriela; Pereira, Daniele Sirineu; Britto, Raquel Rodrigues

doi:10.1007/s40200-023-01205-5

Cited by 2 publications

(2 citation statements)

References 52 publications

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“…However, a recent meta-analysis suggests that interventions longer than 12 weeks do not induce additional benefits on HbA1c ( 54 ). Taken together the results of the included studies reinforce the need for regularity and spacing between physical training sessions, but also the need for progression of the intervention intensity for adequate management and glycemic control ( 55 ).…”

Section: Discussionmentioning

confidence: 67%

Physical exercise as treatment for adults with type 2 diabetes: a rapid review

Ribeiro,

Carvalho,

Bento-Torres

2023

Front. Endocrinol.

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BackgroundType 2 diabetes mellitus (T2DM) is a leading cause of disability-adjusted life years (DALY). Physical exercise is an effective non-pharmacological intervention to promote glycaemic control in T2DM. However, the optimal exercise parameters for glycemic control in individuals with T2DM remain unclear.ObjectiveThis study aimed to analyze the relationship between physical training variables – frequency, intensity, type, duration, volume, and progression – and glycemic control in individuals with T2DM.MethodsA rapid systematic literature review was conducted on PubMed and LILACS databases. The PICOT strategy was employed to define the inclusion criteria. Eligible studies had to assess the impact of exercise parameters (frequency, intensity, type, duration, volume, and progression) on glycemic control indicators, primarily glycosylated hemoglobin (HbA1c). Randomized and non-randomized clinical trials were included in the review. The methodological quality of each study was assessed using the PEDro scale (PROSPERO - CRD 42021262614).ResultsOut of 1188 papers initially identified, 18 reports met the inclusion criteria and were included in the analysis. A total of 1,228 participants with T2DM (1086 in exercise groups) were included in the selected studies. Among these studies, 16 (88.9%) were RCTs and 2 (11.1%) were nRCTs. The age of participants ranged from 43.1 and 68.9 years, and the average intervention duration was 16.8 weeks. Data on adherence to the intervention, adverse events, detailed intervention protocol, and its impacts on glycaemic control, lipid profile, blood pressure, anthropometric measures, medication, body composition, and physical fitness are reported.ConclusionThe evidence supports the safety and effectiveness of physical exercises as non-pharmacological interventions for glycemic control. Aerobic, resistance and combined training interventions were associated with reductions in HbA1c and fasting glucose. The diversity of the physical exercise intervention protocols investigated in the studies included in this review is an important limitation to generalizing evidence-based practice. The call for action is mandatory to implement large-scale education programs on the prevention of diabetes and public health policies aimed to include well-planned and supervised exercise programs as an essential part of the primary prevention of type 2 diabetes.Systematic Review RegistrationPROSPERO, identifier (CRD42021262614).

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Section: Discussionmentioning

confidence: 67%

Physical exercise as treatment for adults with type 2 diabetes: a rapid review

Ribeiro,

Carvalho,

Bento-Torres

2023

Front. Endocrinol.

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“…9,10 Interventions that improve functional exercise capacity (FEC) in individuals with T2D include the insulin-sensitizing agent, rosiglitazone (RO) [11][12][13] and multiple forms of exercise training. 14 Given the RO-responsiveness of FEC and the consistent association between insulin sensitivity and FEC in T2D, we hypothesized that RO might also improve FEC in prediabetes, a stage at which increased physical activity has great potential for delaying T2D onset and ameliorating CVD risk. 15 Coronary artery calcium (CAC) volume 16,17 scores correlate (positively and inversely, respectively) with atherosclerotic burden and CVD risk.…”

Section: Introductionmentioning

confidence: 99%

Rosiglitazone improves insulin resistance but does not improve exercise capacity in individuals with impaired glucose tolerance: A randomized clinical study

Abushamat,

Schauer,

Low Wang

et al. 2024

Journal of Investigative Medicine

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Dysmetabolic states, such as type 2 diabetes (T2D), characterized by insulin resistance (IR), are associated with fatty liver, increased cardiovascular disease (CVD) risk, and decreased functional exercise capacity (FEC). Rosiglitazone (RO) improves exercise capacity and IR in T2D. However, the effects of RO on FEC and other markers of CVD risk in prediabetes are unknown. We hypothesized that insulin sensitization with RO would improve exercise capacity and markers of CVD risk in participants with impaired glucose tolerance (IGT). Exercise performance (peak oxygen consumption and oxygen uptake kinetics), IR (HOMA-IR and QUICKI), and surrogate cardiovascular endpoints [coronary artery calcium (CAC) volume and density and C-reactive protein (CRP)] were measured in participants with IGT after 12 and 18 months of RO or placebo (PL). RO did not significantly improve exercise capacity. Glycemic measures and insulin resistance were significantly lower in people on RO compared to placebo at 18 months. CAC volume progression was not different between PL and RO groups. RO did not improve exercise capacity during an 18-month intervention despite improved IR and glycemia in people with IGT. Future studies should explore why effects on FEC with RO occur in T2D but not IGT. Understanding these questions may help in targeting therapeutic approaches in T2D and IGT.

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Effects of exercise training parameters on cardiorespiratory fitness of individuals with type 2 diabetes mellitus: a systematic review and meta-analysis

Cited by 2 publications

References 52 publications

Physical exercise as treatment for adults with type 2 diabetes: a rapid review

Physical exercise as treatment for adults with type 2 diabetes: a rapid review

Rosiglitazone improves insulin resistance but does not improve exercise capacity in individuals with impaired glucose tolerance: A randomized clinical study

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