Volume of supervised exercise training impacts glycaemic control in patients with type 2 diabetes: a systematic review w

  • PDF / 285,956 Bytes
  • 10 Pages / 595.276 x 790.866 pts Page_size
  • 84 Downloads / 168 Views

DOWNLOAD

REPORT


SYSTEMATIC REVIEW

Volume of supervised exercise training impacts glycaemic control in patients with type 2 diabetes: a systematic review with meta-regression analysis D. Umpierre & P. A. B. Ribeiro & B. D. Schaan & J. P. Ribeiro

Received: 3 May 2012 / Accepted: 29 August 2012 / Published online: 16 November 2012 # Springer-Verlag Berlin Heidelberg 2012

Abstract Aims/hypothesis Supervised exercise programmes improve glycaemic control in type 2 diabetes, but training characteristics associated with reduction in HbA1c remain unclear. We conducted a systematic review with meta-regression analysis of randomised clinical trials (RCTs) assessing the association between intensity and volume of exercise training (aerobic, resistance or combined) and HbA1c changes in patients with type 2 diabetes. Methods Five electronic databases were searched (1980– 2012) to retrieve RCTs of at least 12 weeks' duration, consisting of supervised exercise training vs no intervention, that reported HbA1c changes and exercise characteristics. Two independent reviewers conducted study selection and data extraction. Professor J. P. Ribeiro, who supervised this research, died on 23 August 2012, before publication of this study. Electronic supplementary material The online version of this article (doi:10.1007/s00125-012-2774-z) contains peer-reviewed but unedited supplementary material, which is available to authorised users. D. Umpierre (*) : P. A. B. Ribeiro : J. P. Ribeiro Exercise Pathophysiology Research Laboratory, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, Centro de Pesquisa Clínica–LaFiex, 3° andar, 90035-003 Porto Alegre, RS, Brazil e-mail: [email protected] B. D. Schaan Endocrinology Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil

Results Twenty-six RCTs (2,253 patients) met the inclusion criteria. In multivariate analysis, baseline HbA1c and exercise frequency explained nearly 58% of between-study variance. Baseline HbA1c was inversely correlated with HbA1c reductions after the three types of exercise training. In aerobic training, exercise volume (represented by frequency of sessions) was associated with changes in HbA1c (weighted r0−0.64), while no variables were correlated with glycaemic control induced by resistance training. In combined training, weekly volume of resistance exercise explained heterogeneity in multivariate analysis and was associated with changes in HbA1c levels (weighted r0−0.70). Conclusions/interpretation Reduction in HbA1c is associated with exercise frequency in supervised aerobic training, and with weekly volume of resistance exercise in supervised combined training. Therefore, exercise volume is a major determinant of glycaemic control in patients with type 2 diabetes. Keywords Aerobic exercise . Glycosylated haemoglobin A . Resistance training . Type 2 diabetes mellitus . Systematic review Abbreviations 1-RM One repetition maximum HRmax Maximum heart rate PRISMA Preferred reporting items for systematic reviews and meta-analyses RCT Randomised clinical trial