MacDonald Christopher S, Ried-Larsen Mathias, Soleimani Jalal, Alsawas Mouaz, Lieberman Daniel E, Ismail Abdalla S, Serafim Laura P, Yang Ting, Prokop Larry, Joyner Michael, Murad Mohammad Hassan, Barwise Amelia
The Centre of Inflammation and Metabolism and the Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Diabetes Metab Res Rev. 2021 Nov;37(8):e3444. doi: 10.1002/dmrr.3444. Epub 2021 Mar 26.
Lifestyle interventions are pivotal for successful management of type 2 diabetes (T2D), however, the proportion of people with T2D adhering to physical activity advice has not been thoroughly studied. The purpose of this systematic review was to summarise the evidence on adherence to exercise or physical activity components in lifestyle interventions in those with T2D. We searched MEDLINE EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews and Scopus on 12 November 2019. Eligible studies enrolled adults with T2D and reported the proportion of adherence to lifestyle interventions as a primary or secondary outcome. We included 11 studies (nine randomised controlled trials (RCTs) enrolling 1717 patients and two nonrandomised studies enrolling 62 patients). Only one of the studies had low risk of bias. The proportion of participants adhering to physical activity varied from 32% to 100% with a median of 58%. Adherence was higher in interventions using supervised training and lowest in interventions using remote coaching and the adherence rate in observational studies was higher compared to RCTs (92% vs. 55%; p < 0.01). Study duration, risk of bias, or participants' sex, were not associated with adherence to physical activity. The proportion of those with T2D adhering to physical activity interventions for T2D varies widely and most of the included studies had a high risk of bias. These findings have important implications for planning and power analysis of future trials and when counselling patients about lifestyle interventions including physical activity or exercise components.
生活方式干预对于2型糖尿病（T2D）的成功管理至关重要，然而，坚持体育活动建议的T2D患者比例尚未得到充分研究。本系统评价的目的是总结T2D患者在生活方式干预中坚持运动或身体活动组成部分的证据。我们于2019年11月12日检索了MEDLINE、EMBASE、Cochrane对照试验中心注册库、Cochrane系统评价数据库和Scopus。符合条件的研究纳入了成年T2D患者，并将坚持生活方式干预的比例作为主要或次要结局进行报告。我们纳入了11项研究（9项随机对照试验（RCT），共纳入1717例患者；2项非随机研究，共纳入62例患者）。只有一项研究的偏倚风险较低。坚持体育活动的参与者比例从32%到100%不等，中位数为58%。在使用监督训练的干预中，依从性较高；在使用远程指导的干预中，依从性最低；观察性研究中的依从率高于RCT（92%对55%；p<0.01）。研究持续时间、偏倚风险或参与者性别与坚持体育活动无关。T2D患者坚持T2D体育活动干预的比例差异很大，并且大多数纳入研究存在高偏倚风险。这些发现对于未来试验的规划和功效分析以及在为患者提供包括体育活动或运动组成部分的生活方式干预咨询时具有重要意义。
