Dong Chenyang, Liu Ruoya, Huang Zhiyang, Yang Yang, Sun Shiyuan, Li Ran
School of Sport Science, Beijing Sport University, 48 Xinxi Road, Haidian District, Beijing, China.
Diabetol Metab Syndr. 2023 Nov 14;15(1):232. doi: 10.1186/s13098-023-01209-4.
Most studies about exercise interventions for patients with type 2 diabetes mellitus (T2DM) have been conducted in hospitals or labs, but it is unclear whether study findings from this specific condition can be generalised to real-life T2DM communities. If patients with T2DM can exercise on their own or with family members, it may also reduce the need for patient supervision by medical staff, thereby reducing the burden of medical treatment and improving condition management's cost-effectiveness and practicability. Much of the current research on exercise interventions for T2DM was focused on the type of exercise and less on the mode of management, so we aimed to examine the effect of exercise interventions based on family management or self-management on glycaemic control in patients with T2DM.
Articles were searched from eight Chinese and English databases. Randomized control trials (RCTs) published in English and Chinese, from inception to October 17, 2022, were included in this review. The methodological quality of the included studies was assessed using the RCT risk of bias assessment tool provided by the Cochrane Collaboration's tool. Meta-analysis was performed using Rev Man 5.4 and Stata 15.0 software. Heterogeneity was investigated using sensitivity analysis and subgroup analyses. Publication bias was tested by funnel plot and Egger's asymmetry tests.
A total of 10 studies with a total of 913 subjects were finally included in this review. The Meta-analysis showed that exercise interventions based on family management or self-management were more effective than control groups in reducing HbA1c (Z = 3.90; 95% CI MD = - 0.81; - 1.21 to - 0.40; P < 0.0001), fasting glucose (Z = 4.63; 95% CI MD = - 1.17; - 1.67 to - 0.68; P < 0.00001), 2-h plasma glucose (Z = 5.53; 95% CI MD = - 1.84; - 2.50 to - 1.19; P < 0.00001), and Low-density lipoproteins levels (Z = 3.73; 95% CI MD = - 0.38; - 0.58 to - 0.18; P = 0.0002).
Exercise interventions based on family management or self-management can significantly reduce glycosylated haemoglobin, fasting glucose, 2-h plasma glucose, and Low-density lipoproteins levels in patients with T2DM, which can effectively delay disease progression and reduce the risk of developing complications. In the future, for exercise interventions based on family or self-management, this review recommended that exercise intervention programmes should be formulated according to 30-60 min per session, more than three times per week, for more than six months of aerobic exercise or aerobic combined with resistance exercise.
大多数关于2型糖尿病（T2DM）患者运动干预的研究是在医院或实验室进行的，但尚不清楚从这种特定情况下得出的研究结果是否能推广到现实生活中的T2DM群体。如果T2DM患者能够自行或与家人一起进行运动，也可能减少医护人员对患者的监督需求，从而减轻医疗负担，提高病情管理的成本效益和实用性。目前关于T2DM运动干预的许多研究都集中在运动类型上，而较少关注管理模式，因此我们旨在研究基于家庭管理或自我管理的运动干预对T2DM患者血糖控制的影响。
从八个中英文数据库中检索文章。纳入本综述的是从创刊至2022年10月17日以英文和中文发表的随机对照试验（RCT）。使用Cochrane协作网提供的RCT偏倚风险评估工具对纳入研究的方法学质量进行评估。使用Rev Man 5.4和Stata 15.0软件进行荟萃分析。通过敏感性分析和亚组分析研究异质性。通过漏斗图和Egger不对称检验检测发表偏倚。
本综述最终纳入了10项研究，共913名受试者。荟萃分析表明，基于家庭管理或自我管理的运动干预在降低糖化血红蛋白（Z = 3.90；95%CI MD = -0.81；-1.21至-0.40；P < 0.0001）、空腹血糖（Z = 4.63；95%CI MD = -1.17；-1.67至-0.68；P < 0.00001）、餐后2小时血糖（Z = 5.53；95%CI MD = -1.84；-2.50至-1.19；P < 0.00001）和低密度脂蛋白水平（Z = 3.73；95%CI MD = -0.38；-0.58至-0.18；P = 0.0002）方面比对照组更有效。
基于家庭管理或自我管理的运动干预可以显著降低T2DM患者的糖化血红蛋白、空腹血糖、餐后2小时血糖和低密度脂蛋白水平，有效延缓疾病进展，降低并发症发生风险。未来，对于基于家庭或自我管理的运动干预，本综述建议运动干预方案应按照每次30 - 60分钟、每周三次以上、持续六个月以上的有氧运动或有氧结合抗阻运动来制定。
