运动即改善：运动及一般身体活动对2型糖尿病患者血糖控制的治疗效果：一项随机对照试验的系统评价与荟萃分析

Movement is Improvement: The Therapeutic Effects of Exercise and General Physical Activity on Glycemic Control in Patients with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

作者信息

Shah Sayed Z A, Karam Jawad A, Zeb Alam, Ullah Rafi, Shah Arif, Haq Ijaz Ul, Ali Iftikhar, Darain Haider, Chen Hong

机构信息

Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.

Department of applied exercise science, Concordia University Chicago, 7400 Augusta St., River Forest, IL, 60305, United States.

出版信息

Diabetes Ther. 2021 Mar;12(3):707-732. doi: 10.1007/s13300-021-01005-1. Epub 2021 Feb 5.

DOI:10.1007/s13300-021-01005-1

PMID:33547579

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7947168/

Abstract

INTRODUCTION

Exercise is considered a cornerstone in achieving an optimized blood glucose level and reducing body weight, body mass index (BMI), and waist circumference. This study aimed to investigate and quantitatively summarize the literature regarding the therapeutic effects of exercise and general physical activity on glycemic control.

METHODS

A systematic review and meta-analysis of the literature on the therapeutic effects of exercise on glycemic control in patients with type 2 diabetes mellitus (type 2 DM) were conducted using electronic databases. Studies with an exercise intervention lasting more than 8 weeks were included. Both qualitative and quantitative analyses were performed. Qualitative data were presented narratively in table form. Quantitative analysis was performed using a random-effects model with a 95% confidence interval and a significance level of 0.05. The Physiotherapy Evidence Database (PEDro) scale and the Cochrane Risk of Bias 2 (RoB2) tool were used to assess the quality of evidence and the risk of bias.

RESULTS

A total of 21,559 articles were identified through different databases. Out of 21559 studies, only 32 randomized controlled trials were deemed eligible for inclusion in this study. The average exercise session was 45.15 min, while the average follow-up duration was 21.94 weeks. The mean exercise frequency according to our findings was 3.25 days/week. Almost all the studies reported decreases in glycated hemoglobin (HbA1c; P < 0.0001), fasting blood glucose (P = 0.03), BMI (P = 0.04), and waist circumference (P = 0.007) after the exercise intervention.

CONCLUSION

Exercise plays an important role in optimizing glycemic control and improving quality of life (QoL), BMI, and waist circumference in type 2 DM patients. Exercise could be a safe adjunct therapy to medical treatments in these patients.

REGISTRATION

PROSPERO: CRD42020210816.

摘要

引言

运动被认为是实现优化血糖水平以及降低体重、身体质量指数（BMI）和腰围的基石。本研究旨在调查并定量总结关于运动和一般体力活动对血糖控制的治疗效果的文献。

方法

使用电子数据库对有关运动对2型糖尿病（2型DM）患者血糖控制的治疗效果的文献进行系统综述和荟萃分析。纳入运动干预持续时间超过8周的研究。进行了定性和定量分析。定性数据以表格形式进行叙述性呈现。使用具有95%置信区间和0.05显著性水平的随机效应模型进行定量分析。使用物理治疗证据数据库（PEDro）量表和Cochrane偏倚风险2（RoB2）工具来评估证据质量和偏倚风险。

结果

通过不同数据库共识别出21559篇文章。在21559项研究中，仅有32项随机对照试验被认为符合纳入本研究的条件。平均运动时长为45.15分钟，而平均随访时长为21.94周。根据我们的研究结果，平均运动频率为每周3.25天。几乎所有研究均报告运动干预后糖化血红蛋白（HbA1c；P < 0.0001）、空腹血糖（P = 0.03）、BMI（P = 0.04）和腰围（P = 0.007）有所下降。