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2型糖尿病成人身体活动指南:系统评价

Physical activity guidelines for adults with type 2 Diabetes: Systematic review.

作者信息

Tonga Eda, Worboys Hannah, Evans Rachael A, Singh Sally J, Davies Melanie J, Andre Ng G, Yates Thomas

机构信息

Diabetes Research Centre, College of Life Sciences, Department of Population Health Sciences, University of Leicester, Leicester, UK; NIHR Leicester Biomedical Research Centre, Leicester, UK.

Department of Biostatistics, College of Life Sciences, University of Leicester, Leicester, UK.

出版信息

Diabetes Res Clin Pract. 2025 Feb;220:111982. doi: 10.1016/j.diabres.2024.111982. Epub 2024 Dec 31.

Abstract

AIMS

The aim of this study was to systematically review recommendations on physical activity for adults with type 2 diabetes (T2D).

METHODS

Online databases were searched for clinical practice guidelines (CPGs), statements, and recommendations. Two authors screened the guidelines based on eligibility criteria. FITT (Frequency, Intensity, Time, Type) for physical activity and disease-specific precautions were extracted independently. The methodological quality of CPGs was assessed using the AGREE II instrument. Recommendations were categorized according to FITT, with disease-specific adaptations also recorded.

RESULTS

Fifteen guidelines were included. Nine underwent AGREE II evaluation, with three rated high quality and the rest moderate to low. The predominant recommendation was to engage in at least 150 min of moderate aerobic exercise per week. Adaptations for T2D focused on glucose levels, diet, foot care, weather conditions, sedentary behaviour, neuropathy, and retinopathy.

CONCLUSION

While guidelines consistently recommended aerobic exercise, there was limited emphasis on strength and flexibility exercises. Significant limitations in methodological and reporting quality were noted, especially in stakeholder involvement and applicability. Future guidelines should use a standardized FITT framework and adhere to standard development methods to enhance usability for healthcare professionals and patients.

摘要

目的

本研究旨在系统回顾针对2型糖尿病(T2D)成人的身体活动建议。

方法

检索在线数据库以查找临床实践指南(CPG)、声明和建议。两位作者根据纳入标准筛选指南。独立提取身体活动的FITT(频率、强度、时间、类型)以及特定疾病的预防措施。使用AGREE II工具评估CPG的方法学质量。建议根据FITT进行分类,并记录特定疾病的调整内容。

结果

纳入了15项指南。9项接受了AGREE II评估,其中3项评为高质量,其余为中低质量。主要建议是每周进行至少150分钟的中等强度有氧运动。针对T2D的调整集中在血糖水平、饮食、足部护理、天气状况、久坐行为、神经病变和视网膜病变。

结论

虽然指南一致推荐有氧运动,但对力量和柔韧性锻炼的强调有限。注意到方法学和报告质量存在显著局限性,尤其是在利益相关者参与和适用性方面。未来的指南应使用标准化的FITT框架并遵循标准的制定方法,以提高对医疗保健专业人员和患者的可用性。

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