Grace Aimee, Chan Erick, Giallauria Francesco, Graham Petra L, Smart Neil A
School of Science and Technology, University of New England, Armidale, NSW, 2351, Australia.
School of Medicine, Griffith University, Gold Coast, Australia.
Cardiovasc Diabetol. 2017 Mar 14;16(1):37. doi: 10.1186/s12933-017-0518-6.
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) 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%.
确定有氧运动训练是否对II型糖尿病患者的临床结局和血糖状况有有益影响。
通过检索MEDLINE（1985年至2016年9月1日）、Cochrane对照试验注册库（1966年至2016年9月1日）、CINAHL、SPORTDiscus和科学引文索引进行系统检索，以识别相关研究。检索策略包括混合使用与相关关键概念对应的医学主题词和自由文本词。检索限于针对年龄大于18岁、持续时间超过2周的II型糖尿病患者进行的有氧运动训练的前瞻性随机或对照试验。
我们的分析纳入了27项研究（38个干预组），共计1372名参与者，其中737名来自运动组，635名来自对照组。这些研究包含来自39435个患者小时的运动训练数据。我们的分析显示，运动可改善糖化血红蛋白（HbA1C%），MD：-0.71%，95%CI -1.11，-0.31；p值 = 0.0005。存在显著的调节效应；每增加一周运动，HbA1C%降低0.009%至0.04%，p = 0.002。与进行低强度或中等强度活动的人相比，进行高强度运动的人峰值摄氧量（peak VO）进一步增加0.64和5.98 ml/kg/min。运动还改善了胰岛素抵抗的稳态模型评估（HOMA-IR），MD：-1.02，95%CI -1.77，-0.28；p值 = 0.007；空腹血糖MD：-12.53 mmol/l，95%CI -18.94，-6.23；p值<0.0001；以及血清MD：-10.39 IU，95%CI -17.25，-3.53；p值 = 0.003。
我们的分析支持现有指南，即对于能够耐受的人，更高强度的运动可能带来更好的健康益处，更长的运动计划持续时间将优化HbA1C%的降低。
