Department of Rehabilitation Sciences, Ziauddin University, Karachi, Pakistan.
J Coll Physicians Surg Pak. 2024 Nov;34(11):1355-1363. doi: 10.29271/jcpsp.2024.11.1355.
The effectiveness of concurrent exercise (CE) as an emerging approach for type-II diabetes mellitus (T2DM) patients was evaluated through a comprehensive search on Google Scholar, PubMed, Pedro, CINAHL, and Medline from 2015 to March 2023. Sixteen RCTs were selected which evaluated CE (aerobic + resistance in the same session) effects on a minimum of three days/week among T2DM patients, and the control group received usual care or no exercise. Studies that evaluated at least one glycaemic variable, i.e. HbA1C, fasting blood glucose level (FBGL), and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), were eligible. Intervention with a follow-up period of ≥8 weeks, patients of any age and gender, and literature in the English language were included. A rigorous review was performed using the Cochrane Collaboration risk of bias tool (RoB 2) to minimise biases, which include the randomisation process, deviation from intended intervention, missing outcome data, outcome measurement, and selection bias. CE significantly improved HbA1C (95% CI of -0.654 to 0.363, I2 = 84.92% moderate heterogeneity), FBGL (95% CI of -0.239 to 1.145, I2 = 93.74% - high level of heterogeneity), and insulin resistance (HOMA-IR) (95% CI of -0.593 to 0.544, I2 = 92.85% - high level of heterogeneity). Collectively, findings indicate the potential of CE as an intervention to impact glycaemic control in T2DM patients positively. However, the relatively high I² values suggest notable variability among studies, and further research to explore the factors contributing to this heterogeneity, exercise protocol along with progression, and duration of diabetes are needed, which is more challenging to determine a precise dose-response relationship. Therefore, more studies are required to provide thorough insights into these components for T2DM management. Key Words: Glycated haemoglobin, Glycaemic control, Insulin resistance, Physical exercise, Type-II diabetes mellitus.
从 2015 年到 2023 年 3 月，通过在 Google Scholar、PubMed、 Pedro、CINAHL 和 Medline 上全面搜索，评估了并发运动（CE）作为 2 型糖尿病（T2DM）患者的一种新兴方法的有效性。选择了 16 项随机对照试验（RCT），这些试验评估了 CE（同一次有氧和阻力运动）对 T2DM 患者每周至少 3 天的影响，对照组接受常规护理或不运动。符合条件的研究评估了至少一个血糖变量，即糖化血红蛋白（HbA1C）、空腹血糖水平（FBGL）和胰岛素抵抗稳态模型评估（HOMA-IR）。干预措施的随访时间≥8 周，患者年龄和性别不限，文献为英文。使用 Cochrane 协作风险偏倚工具（RoB 2）进行严格审查，以最大程度地减少偏倚，包括随机化过程、偏离预期干预、缺失结局数据、结局测量和选择偏倚。CE 显著改善了 HbA1C（95%置信区间为-0.654 至 0.363，I2 = 84.92%中度异质性）、FBGL（95%置信区间为-0.239 至 1.145，I2 = 93.74%高度异质性）和胰岛素抵抗（HOMA-IR）（95%置信区间为-0.593 至 0.544，I2 = 92.85%高度异质性）。总体而言，这些发现表明 CE 作为一种干预措施，具有积极影响 T2DM 患者血糖控制的潜力。然而，相对较高的 I²值表明研究之间存在显著差异，需要进一步研究以探索导致这种异质性的因素、运动方案以及糖尿病的进展和持续时间，这更难以确定精确的剂量反应关系。因此，需要更多的研究来提供深入了解这些成分对 T2DM 管理的作用。
糖化血红蛋白、血糖控制、胰岛素抵抗、体力活动、2 型糖尿病。
