Effect of lifestyle intervention in patients with type 2 diabetes: A meta-analysis
Open accessAbstract
OBJECTIVE: The effect of lifestyle intervention on clinical risk factors in patients with type 2 diabetes is unclear. The aim of this meta-analysis was to evaluate the effects of comprehensive lifestyle change, such as diet, exercise, and education, on clinical markers that are risk-factors for cardiovascular disease in patients with type 2 diabetes. METHODS: We searched Medline, Cochrane, EMBASE, and Google Scholar (up to August 31, 2013) for randomized controlled trials that compared standard of care (control group) with treatment regimens that included changes in lifestyle (intervention group). The primary outcome was reduction in risk factors of cardiovascular disease including body mass index (BMI), glycated hemoglobin (HbA1c), systolic blood pressure (SBP), diastolic blood pressure (DBP), high-density lipoprotein cholesterol (HDL-c), and low-density lipoprotein cholesterol (LDL-c). RESULTS: A total of 16 studies were included in the meta-analysis. The standardized difference in means of change from baseline significantly favored the intervention compared with the control group in BMI (-0.29; 95% CI, -0.52 to -0.06, P=0.014), HbA1c (-0.37; 95% CI, -0.59 to -0.14, P=0.001), SBP (-0.16: 95% CI, -0.29 to -0.03, P=0.016), DBP (-0.27, 95% CI=-0.41 to -0.12, P<0.001). There was no difference between the intervention and control groups in HDL-c (0.05; 95% CI, -0.10 to 0.21; P=0.503) and LDL-c (-0.14; 95% CI, -0.29 to 0.02; P=0.092). CONCLUSIONS: The meta-analysis found that lifestyle intervention showed significant benefit in risk factors that are known to be associated with development of cardiovascular disease in patients with type 2 diabetes.
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An increased animal fat (saturated fatty acid [SFA]) intake has been shown to be associated with the risk of diabetes.
“an increased animal fat (saturated fatty acid [SFA]) intake has been shown to be associated with the risk of diabetes 19 , 20 , 21 , 22 , 23 .”
From Japanese clinical practice guideline for diabetes 2019 (2020) · cites this paper as [19]
DPP-4 inhibitors appear to have a favorable safety profile.
“Thus, at present, DPP‐4 inhibitors appear to have a favorable safety profile 19 , 20 , 21 , 22 , while attention needs to be given to the potential onset of acute pancreatitis and bullous pemphigoid with these agents.”
From Japanese clinical practice guideline for diabetes 2019 (2020) · cites this paper as [19]
Diabetes is often associated with depressive symptoms and anxiety disorders specific to the disease.
“Diabetes is often associated with depressive symptoms and anxiety disorders specific to the disease 18 , 19 , 20 , leading to suboptimal self‐care, worsening of glycemic control, an increased risk of diabetic complications, and an impaired QOL, thus adversely affecting the prognosis of affected patients 21 , 22 .”
From Japanese clinical practice guideline for diabetes 2019 (2020) · cites this paper as [19]
There is a positive dose-response relationship between glycemic index or glycemic load and the risk of type 2 diabetes.
“There is a positive dose‐response relationship between qualitative markers of carbohydrate, i.e., glycemic index (GI) or glycemic load (GL), and the risk of type 2 diabetes 18 , 19 .”
From Japanese clinical practice guideline for diabetes 2019 (2020) · cites this paper as [19]
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- Authors
- Chen, L., Pei, J.-H., Kuang, J., Chen, H.-M., Chen, Z., Li, Z.-W., & Yang, H.-Z.
- Affiliations
- Guangdong General Hospital (CN)
- Corresponding author
- Chen, Liang
- Venue
- Metabolism
- Publisher
- Elsevier BV
- Published
- 2015-02
- Volume
- 64
- Issue
- 2
- Pages
- 338-347
- ISSN
- 0026-0495 (ISSN-L)
- OpenAlex
- W2085848038
- Cited by
- 343
- References
- 33
- Citations by year
- 2026: 12 · 2025: 33 · 2024: 28 · 2023: 24 · 2022: 39 · 2021: 43 · 2020: 42 · 2019: 37 · 2018: 26 · 2017: 22 · 2016: 19 · 2015: 17 · 2014: 1
- FWCI
- 3.13
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Metabolism (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- type 2 diabetes, lifestyle intervention, cardiovascular risk factors, HbA1c, body mass index, blood pressure, HDL cholesterol, LDL cholesterol, diet, physical activity, diabetes education
- MeSH terms
- Cardiovascular Diseases, Combined Modality Therapy, Diabetes Mellitus, Type 2, Diabetic Angiopathies, Humans, Life Style, Risk Factors, Randomized Controlled Trials as Topic, Diabetic Cardiomyopathies
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