A systematic review and meta-analysis of exercise interventions in adults with type 1 diabetes |
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| Affiliation: | 1. College of Nursing, New York University College of Nursing, 433 First Avenue #404, New York, NY 10010, United States;2. Helen Porter Jayne and Martha Prosser Jayne Professor of Nursing, Yale School of Nursing, 400 West Campus Drive, Orange, CT 06477, United States;3. Annie Goodrich Professor, Yale School of Nursing, 400 West Campus Drive, Orange, CT 06477, United States;1. Diabetes Centre, Department of Endocrinology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia;2. Sydney Medical School, University of Sydney, Sydney, NSW, Australia;3. Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia;4. Faculty of Health Sciences, The University of Sydney, Sydney, NSW 2006, Australia;1. Barbara Davis Center for Childhood Diabetes, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States;2. Colorado School of Public Health, Anschutz Medical Campus, Aurora, CO, United States;3. Indiana University School of Medicine, Indianapolis, IN, United States |
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| Abstract: | AimsConflicting evidence exists regarding the benefits of physical activity for long-term blood glucose control in adults with type 1 diabetes (T1D). The object of this systematic review was to determine the effects of physical activity on long-term blood glucose control in T1D adults.MethodsPubMed/Medline, Embase, CENTRAL, SPORTdiscus, Global Health and ICTRP were searched up to October 2013 for randomized trials of aerobic or resistance exercise training in T1D adults. Exercises had to be performed at least twice weekly for a minimum of two months. The primary outcome was glycated hemoglobin (HbA1c). Secondary outcomes included cardiorespiratory fitness and insulin dose.ResultsSix randomized trials were identified (323 adults); sample sizes ranged from n = 6 to n = 148 participants receiving the intervention. Five trials had an unknown risk of bias; one trial was deemed to be at high risk of bias. Exercise frequency varied from twice weekly to daily, with intensities (50–90% VO2peak), and session durations (20–120 min) varying widely. Four trials reported HbA1c, which decreased with exercise training (mean difference [MD] −0.78% (−9 mmol/mol), 95% CI −1.14 (−13 mmol/mol) to −0.41 (−5 mmol/mol); p < 0.0001; I2 0%) compared with controls. Exercise training improved cardiorespiratory fitness by 3.45 ml/kg/min (95% CI 0.59 to 6.31, p = 0.02, I2 0%) compared with controls. One trial reported an effect on insulin dose (MD −0.4 U/kg, 95% CI −0.53 to −0.27, p < 0.00001) compared to controls.ConclusionThere are currently insufficient well-designed studies to ascertain the true effect of exercise training on HbA1c in individuals with T1D, but current results are promising. |
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| Keywords: | Physical activity Glycemic control Type 1 diabetes |
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