Cited by 56Physical Activity and HealthDiabetes, Cardiovascular Risks, and LipoproteinsDiabetes Management and Research

Exercise modalities for type 2 diabetes: a systematic review and network meta-analysis of randomized trials

Hou, Liangying, Wang, Qi, Pan, Bei, Li, Rui, Li, Yanfei, He, Juanjuan, Qin, Tianzhu, Cao, Liujiao +4 more·2023·Diabetes/Metabolism Research and Reviews

Abstract

AIMS: We aimed to determine the effects of different exercise modalities in patients with type 2 diabetes mellitus (T2DM). METHODS: We 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. RESULTS: A 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. CONCLUSIONS: Overall, 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.

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Crossref · 10.1002/dmrr.3591

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Authors
Hou, L., Wang, Q., Pan, B., Li, R., Li, Y., He, J., Qin, T., Cao, L., Zhang, N., Cao, C., Ge, L., & Yang, K.
Affiliations
  • Lanzhou University (CN)
  • Sichuan University (CN)
Venue
Diabetes/Metabolism Research and Reviews
Publisher
Wiley
Published
2022-12-04
Volume
39
Issue
1
Pages
e3591-e3591
ISSN
  • 1520-7552 (ISSN-L)
  • 1520-7560
OpenAlex
W4309921269
Cited by
56
References
48
Citations by year
2026: 13 · 2025: 18 · 2024: 22 · 2023: 3
FWCI
1.48
Type
journal article
Language
en
Open access
closed
Locations
  • Diabetes/Metabolism Research and Reviews (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Keywords
type 2 diabetes, exercise modalities, supervised exercise, aerobic exercise, resistance training, flexibility training, balance training, glycemic control, HbA1c, fasting blood glucose, body weight, blood pressure, lipid profile, total cholesterol, triglycerides
MeSH terms
Network Meta-Analysis, Adult, Diabetes Mellitus, Type 2, Glycated Hemoglobin, Humans, Lipids, Randomized Controlled Trials as Topic

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