Clinical outcomes and glycaemic responses to different aerobic exercise training intensities in type II diabetes: a systematic review and meta-analysis
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To establish if aerobic exercise training is associated with beneficial effects on clinical outcomes and glycaemic profile in people with type II diabetes. A systematic search was conducted to identify studies through a search of MEDLINE (1985 to Sept 1, 2016, Cochrane Controlled Trials Registry (1966 to Sept 1, 2016), CINAHL, SPORTDiscus and Science Citation Index. The search strategy included a mix of MeSH and free text terms for related key concepts. Searches were limited to prospective randomized or controlled trials of aerobic exercise training in humans with type II diabetes, aged >18 years, lasting >2 weeks. Our analysis included 27 studies (38 intervention groups) totalling 1372 participants, 737 exercise and 635 from control groups. The studies contain data from 39,435 patient-hours of exercise training. Our analyses showed improvements with exercise in glycosylated haemoglobin (HbA1C%) MD: −0.71%, 95% CI −1.11, −0.31; p value = 0.0005. There were significant moderator effects; for every additional week of exercise HbA1C% reduces between 0.009 and 0.04%, p = 0.002. For those exercising at vigorous intensity peak oxygen consumption (peak VO 2 ) increased a further 0.64 and 5.98 ml/kg/min compared to those doing low or moderate intensity activity. Homeostatic model assessment of insulin resistance (HOMA-IR) was also improved with exercise MD: −1.02, 95% CI −1.77, −0.28; p value = 0.007; as was fasting serum glucose MD: −12.53 mmol/l, 95% CI −18.94, −6.23; p value <0.0001; and serum MD: −10.39 IU, 95% CI −17.25, −3.53; p value = 0.003. Our analysis support existing guidelines that for those who can tolerate it, exercise at higher intensity may offer superior fitness benefits and longer program duration will optimize reductions in HbA1C%.
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No previous meta-analysis has found the optimal type or dose of physical activity to control HbA1c in type 2 diabetes.
“none found the optimal type or dose of physical activity to verify the validity and reliability of these recommendations”
From Optimal Dose and Type of Physical Activity to Improve Glycemic Control in People Diagnosed With Type 2 Diabetes: A Systematic Review and Meta-analysis (2024) · cites this paper as [12]
The Background says prior research found combined aerobic and resistance exercise most beneficial for glycaemic control, but it does not say whether previous meta-analyses established an optimal type or dose. The Study limitations section describes gaps in this review’s analyses, not whether earlier meta-analyses validated exercise recommendations. No page numbers are available in our copy. (LLM, conf=0.72)
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- Authors
- Grace, A., Chan, E., Giallauria, F., Graham, P. L., & Smart, N. A.
- Affiliations
- University of New England (AU)
- Griffith University (AU)
- Federico II University Hospital (IT)
- Macquarie University (AU)
- Corresponding author
- Smart, Neil A.
- Venue
- Cardiovascular Diabetology
- Published
- 2017-03-14
- Volume
- 16
- Issue
- 1
- Pages
- 37-37
- ISSN
- 1475-2840 (ISSN-L)
- PMC
- PMC5351065
- OpenAlex
- W2600366653
- Cited by
- 174
- References
- 52
- Citations by year
- 2026: 6 · 2025: 22 · 2024: 15 · 2023: 41 · 2022: 23 · 2021: 15 · 2020: 12 · 2019: 21 · 2018: 15 · 2017: 4
- FWCI
- 1.75
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Cardiovascular Diabetology (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Griffith Research Online (submittedVersion, cc-by)
- RUNE (Research UNE) (submittedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- type 2 diabetes, aerobic exercise training, exercise intensity, glycemic control, HbA1c, insulin resistance, HOMA-IR, fasting serum glucose, peak oxygen uptake, exercise duration
- MeSH terms
- Blood Glucose, Diabetes Mellitus, Type 2, Physical Exertion, Humans, Body Mass Index, Randomized Controlled Trials as Topic, Treatment Outcome
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