Xing Shuangtao, Zhang Yifan, Chen Yanjiao, Feng Shijie, Zhang Yiqing, Moreira Paulo
Physical Education Institute of Henan Normal University, Henan, Xinxiang, China.
Department of Public Basic Education of Henan Vocational University of Science and Technology, Henan, Zhoukou, China.
Front Endocrinol (Lausanne). 2025 May 5;16:1495131. doi: 10.3389/fendo.2025.1495131. eCollection 2025.
Exercise interventions are a recommended method of diabetes management through which patients can achieve blood glucose control, increase muscle volume, and improve insulin sensitivity, while also improving blood lipids, blood pressure, and cardiovascular health. A few studies on the effects of physical exercise on diabetic patients have been published in recent years. This article focuses on exploring evidence on which exercise interventions generate which effects in diabetic patients, namely, high-intensity interval training (HIIT), method training (MT), aerobic exercise training (AET), resistance training (RT), and combined training (CBT).
Randomized controlled trials (RCTs) that focused on the effects of exercise interventions on blood glucose and blood lipids of patients with type 2 diabetes mellitus were reviewed. A network meta-analysis was performed to compare the effects of the five exercise interventions in diabetic patients, namely the impacts on glycosylated hemoglobin (HbA1c), fasting blood glucose (FBG), total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL), and low-density lipoprotein (LDL). The study was strictly conducted following the PRISMA Protocol, and the Cochrane Risk of Bias Assessment Tool 2.0 was used to objectively evaluate the risk of bias in the implementation of the study.
This review included 25 RCTs in total, with 1,711 subjects. Meta-analysis suggests that, compared with conventional therapeutic treatment, exercise interventions can reduce blood glucose indexes, namely HbA1c, FBG, TC, TG, HDL, and LDL. RT and AET have been shown to reduce TC; HIIT, MT, AET, and CBT have been shown to improve HDL; and HIIT, MT, AET, and CBT have been shown to improve HDL. The MT and RT exercise types can reduce LDL. Evidence also suggests that MT can lower HbA1c, TG, and LDL levels, and RT lowers cholesterol levels. HIIT exercise appears to improve FBG and HDL levels.
The five types of exercise generate different effects on the key clinical dimensions of diabetes. MT seems to be the optimal choice to improve HbA1c, TG levels, and LDL, while HIIT improves FBG and HDL levels, whereas RT exercise appears to be the optimal exercise to lower cholesterol levels.
运动干预是糖尿病管理的推荐方法，患者可通过该方法实现血糖控制、增加肌肉量并提高胰岛素敏感性，同时还能改善血脂、血压和心血管健康。近年来已发表了一些关于体育锻炼对糖尿病患者影响的研究。本文重点探讨哪些运动干预对糖尿病患者产生何种影响的证据，即高强度间歇训练（HIIT）、方法训练（MT）、有氧运动训练（AET）、抗阻训练（RT）和联合训练（CBT）。
对关注运动干预对2型糖尿病患者血糖和血脂影响的随机对照试验（RCT）进行综述。进行网络荟萃分析以比较这五种运动干预对糖尿病患者的影响，即对糖化血红蛋白（HbA1c）、空腹血糖（FBG）、总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白（HDL）和低密度脂蛋白（LDL）的影响。该研究严格按照PRISMA方案进行，并使用Cochrane偏倚风险评估工具2.0客观评估研究实施中的偏倚风险。
本综述共纳入25项RCT，涉及1711名受试者。荟萃分析表明，与传统治疗方法相比，运动干预可降低血糖指标，即HbA1c、FBG、TC、TG、HDL和LDL。已证明RT和AET可降低TC；已证明HIIT、MT、AET和CBT可提高HDL；并且已证明HIIT、MT、AET和CBT可提高HDL。MT和RT运动类型可降低LDL。证据还表明，MT可降低HbA1c、TG和LDL水平，RT可降低胆固醇水平。HIIT运动似乎可改善FBG和HDL水平。
这五种运动对糖尿病的关键临床指标产生不同影响。MT似乎是改善HbA1c、TG水平和LDL的最佳选择，而HIIT可改善FBG和HDL水平，而RT运动似乎是降低胆固醇水平的最佳运动。
