Structured exercise regimens and glycemic control in diabetics

January 01, 0001

Structured exercise regimens and glycemic control in diabetics

Exercise is thought to play a role in glucose control, but the effect of different types of exercise regimens is not well characterized. These Brazilian researchers performed a systematic review of randomized controlled trials looking at aerobic, resistance, and combinged exercise training regimens and physical activity advice in patients with type 2 diabeted and the affects on glycemic control as measured by hemoglobin A1c (HbA1c). They searched MEDLINE, Cochrane-CENTRAL, EMBASE, ClinicalTrials.gov, LILACS, and SPORTDiscus databases yielding 47 trials (8538 patients) that were analyzed using a random effects model.

The researchers found: "Overall, structured exercise training (23 studies) was associated with a decline in HbA1c level (-0.67) compared with control participants. In addition, structured aerobic exercise (-0.73), structured resistance training (-0.57), and both combined (-0.51) were each associated with declines in HbA1C levels compared with control participants. Structured exercise durations of more than 150 minutes per week were associated with HbA1c reductions of 0.89%, while structured exercise durations of 150 minutes or less per week were associated with HbA1C reductions of 0.36%. Overall, interventions of physical activity advice (24 studies) were associated with lower HbA1c levels (-0.43) compared with control participants. Combined physical activity advice and dietary advice was associated with decreased HbA1c (-0.58%) as compared with control participants. Physical activity advice alone was not associated with HbA1c changes."

The researchers concluded: "Structured exercise training that consists of aerobic exercise, resistance training, or both combined is associated with HbA1c reduction in patients with type 2 diabetes. Structured exercise training of more than 150 minutes per week is associated with greater HbA1c declines than that of 150 minutes or less per week. Physical activity advice is associated with lower HbA1c, but only when combined with dietary advice."

This systematic review helps to quantify the benefit of structured exercise and dietary advice on HbA1c in diabietic patients, and shows

For the full abstract, click here.

JAMA 305(17):1790-1799, 4 May 2011 © 2011 American Medical Association
Physical Activity Advice Only or Structured Exercise Training and Association With HbA1c Levels in Type 2 Diabetes. Daniel Umpierre, Paula A. B. Ribeiro, Caroline K. Kramer, et al.

Category: T. Endocrine/Metabolic/Nutritional. Keywords: diabetes, exercise, structured exercise, advice, HbA1c, systematic review with meta-analysis, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 26 July 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.