Melbourne Medical School, the University of Melbourne, Melbourne, VIC.
UNSW Sydney, Sydney, NSW.
Med J Aust. 2024 Nov 4;221(9):486-490. doi: 10.5694/mja2.52483. Epub 2024 Oct 21.
To review evidence regarding the impact of physical activity interventions for preventing and managing type 2 diabetes in Aboriginal and Torres Strait Islander Australians.
We searched for published reports of physical activity interventions for preventing and managing type 2 diabetes in Indigenous adults (18 years or older). There were no exclusion criteria regarding study type or duration, frequency, length, or intensity of physical activity, except that short term interventions were excluded. We assessed the quality of each study using the Joanna Briggs Institute (JBI) critical appraisal tools and the ethical and methodological quality of studies from an Indigenous Australian perspective with the Centre of Research Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange (CREATE) Critical Appraisal Tool.
MEDLINE; Scopus, Embase (Elsevier); Cumulative Index to Nursing and Allied Health Literature (CINAHL), Sports Discus, PsycINFO (EBSCO); Informit Complete; ProQuest Dissertations and Theses, and ProQuest Health and Medicine; each from their inception to 30 October 2022.
The database searches identified 703 potentially relevant records; after removing duplicates and initial screening, the full text of 27 articles was assessed for eligibility. Nine studies met our inclusion criteria: two randomised controlled trials, five cohort studies, one quasi-experimental study, and one repeated cross-sectional study. Eight studies were rated as being of low or medium quality (median JBI score, 54%; interquartile range [IQR], 36-64%); seven studies were rated as being of low to medium ethical and methodological quality from the Indigenous perspective (median CREATE score, 50%; IQR, 36-64%). Six studies reported changes in glycated haemoglobin (HbA) levels, of which two (both cohort studies) reported significantly lower mean HbA levels after the intervention, but only one publication provided detailed results. No randomised controlled trials that investigated the effect of a combination of physical activity and dietary change for Indigenous Australians diagnosed with type 2 diabetes were identified. Differences in study design, outcome variables, and the small number of studies precluded meta-analysis.
Quality research into the impact of physical activity interventions on type 2 diabetes in Indigenous people is sparse. To improve research translation, studies that involve Indigenous community members at all levels of the research process are needed.
PROSPERO CRD42021247496 (prospective).
综述体力活动干预预防和管理澳大利亚原住民和托雷斯海峡岛民 2 型糖尿病的效果证据。
我们检索了预防和管理成年土著人（18 岁及以上）2 型糖尿病的体力活动干预措施的已发表报告。除了排除短期干预措施外，我们没有关于研究类型或持续时间、频率、长度或体力活动强度的排除标准。我们使用 Joanna Briggs 研究所（JBI）的批判性评估工具评估每项研究的质量，并使用原住民澳大利亚视角下的原住民慢性病知识转化与交流卓越研究中心（CREATE）批判性评估工具评估研究的伦理和方法学质量。
MEDLINE；Scopus、Embase（Elsevier）；Cumulative Index to Nursing and Allied Health Literature（CINAHL）、Sports Discus、PsycINFO（EBSCO）；Informit Complete；ProQuest Dissertations and Theses、ProQuest Health and Medicine；每个数据库从成立到 2022 年 10 月 30 日。
数据库检索确定了 703 篇潜在相关记录；在去除重复项和初步筛选后，评估了 27 篇文章的全文以确定其纳入标准。9 项研究符合我们的纳入标准：2 项随机对照试验、5 项队列研究、1 项准实验研究和 1 项重复横断面研究。8 项研究的 JBI 评分为低或中（中位数 54%；四分位距[IQR]，36-64%）；从原住民角度来看，7 项研究的伦理和方法学质量为低至中（中位数 CREATE 评分为 50%；IQR，36-64%）。6 项研究报告了糖化血红蛋白（HbA）水平的变化，其中 2 项（均为队列研究）报告干预后 HbA 水平显著降低，但只有 1 项研究提供了详细结果。未发现针对已诊断为 2 型糖尿病的澳大利亚原住民进行的体力活动和饮食改变联合干预效果的随机对照试验。不同的研究设计、结局变量以及研究数量较少，使得荟萃分析变得不可行。
体力活动干预对原住民 2 型糖尿病影响的高质量研究很少。为了促进研究转化，需要让原住民社区成员参与到研究过程的各个层面。
PROSPERO CRD42021247496（前瞻性）。
