Lifestyle interventions are pivotal for successful management of type 2 diabetes (T2D), however, the proportion of people with T2D adhering to physical activity advice has not been thoroughly studied. The purpose of this systematic review was to summarise the evidence on adherence to exercise or physical activity components in lifestyle interventions in those with T2D. We searched MEDLINE EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews and Scopus on 12 November 2019. Eligible studies enrolled adults with T2D and reported the proportion of adherence to lifestyle interventions as a primary or secondary outcome. We included 11 studies (nine randomised controlled trials (RCTs) enrolling 1717 patients and two nonrandomised studies enrolling 62 patients). Only one of the studies had low risk of bias. The proportion of participants adhering to physical activity varied from 32% to 100% with a median of 58%. Adherence was higher in interventions using supervised training and lowest in interventions using remote coaching and the adherence rate in observational studies was higher compared to RCTs (92% vs. 55%; p < 0.01). Study duration, risk of bias, or participants' sex, were not associated with adherence to physical activity. The proportion of those with T2D adhering to physical activity interventions for T2D varies widely and most of the included studies had a high risk of bias. These findings have important implications for planning and power analysis of future trials and when counselling patients about lifestyle interventions including physical activity or exercise components.

中文翻译：

---

对 2 型糖尿病患者坚持身体活动干预措施的系统评价

生活方式干预对于成功管理 2 型糖尿病 (T2D) 至关重要，但是，遵守身体活动建议的 T2D 患者比例尚未得到彻底研究。本系统评价的目的是总结 T2D 患者在生活方式干预中坚持运动或体力活动成分的证据。我们于 2019 年 11 月 12 日检索了 MEDLINE EMBASE、Cochrane 对照试验中央注册库、Cochrane 系统评价数据库和 Scopus。符合条件的研究纳入了患有 T2D 的成人，并报告了坚持生活方式干预的比例作为主要或次要结局。我们纳入了 11 项研究（九项随机对照试验 (RCT) 招募了 1717 名患者，两项非随机研究招募了 62 名患者）。只有一项研究的偏倚风险较低。坚持体育活动的参与者比例从 32% 到 100% 不等，中位数为 58%。使用监督培训的干预措施的依从性较高，而使用远程指导的干预措施的依从性最低，并且观察性研究的依从率高于随机对照试验（92% vs. 55%；p < 0.01 ）  。研究持续时间、偏倚风险或参与者的性别与坚持体育活动无关。坚持对 T2D 进行体力活动干预的 T2D 患者比例差异很大，大多数纳入的研究都存在很高的偏倚风险。这些发现对于未来试验的规划和功效分析以及向患者提供有关生活方式干预（包括体力活动或运动成分）的咨询具有重要意义。