Purpose

The aim of the study was to evaluate the relationship between changes in hemoglobin A₁c (HbA_1c) and exercise levels in type 2 diabetes mellitus (T2DM) patients when performing various types of exercise.

Methods

The inclusion criteria were randomized controlled trials involving adults with T2DM, intervention involving exercise alone, the overall duration of intervention ≥12 weeks, and reporting HbA_1c. Weighted mean difference (WMD) was defined as the mean difference between the intervention group and the control group weighted by the inverse of the squared standard error for each study, and all WMDs were pooled as overall effects. A meta-regression analysis was performed to evaluate the relationship between the exercise level and the WMD in HbA_1c.

Results

Forty-eight studies (2395 subjects) were analyzed. The pooled WMD in HbA_1c decreased significantly (−0.5% [95% confidence intervals: −0.6 to −0.4]) but contained significant heterogeneity (Q = 103.8, P < 0.01; I² = 36.6%). A meta-regression analysis showed that the intensity (metabolic equivalents [METs]), time (min/session), or frequency (sessions/week) of the exercise was not associated with the HbA_1c. However, the overall duration of exercise (weeks) was significantly associated with the WMD in HbA_1c (meta-regression coefficient: 0.01 [95% confidence intervals: 0.002−0.016]; R² = 70.0%), and that result did not contain significant heterogeneity (P > 0.05; I² = 14.7%).

Conclusions

The exercise intervention decreases HbA_1c in T2DM patients. In addition, exercise for an extended duration was associated with an increase in HbA_1c, so the effects of exercise may be evident early on, but results suggested that exercise for a prolonged period alone may increase HbA_1c.

中文翻译：

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2型糖尿病患者运动水平与血红蛋白A1c的关系：系统评价和荟萃分析

目的

该研究的目的是评估2 型糖尿病 (T2DM) 患者在进行各种类型的运动时血红蛋白 A ₁ c (HbA _1c ) 的变化与运动水平之间的关系。

方法

纳入标准是随机对照试验，涉及 T2DM 成人，干预仅涉及运动，干预的总持续时间≥12 周，并报告 HbA _1c。加权平均差 (WMD) 定义为干预组和对照组之间的平均差，按每项研究的标准误差平方的倒数加权，所有 WMD 汇总为总体效应。进行了元回归分析以评估运动水平与 HbA _{1c 中}WMD 之间的关系。

结果

分析了 48 项研究（2395 名受试者）。HbA _{1c 中}的合并 WMD显着降低（-0.5% [95% 置信区间：-0.6 至 -0.4]），但包含显着的异质性（Q  = 103.8，P  < 0.01；I ²  = 36.6%）。元回归分析表明，运动的强度（代谢当量 [METs]）、时间（分钟/次）或频率（次/周）与 HbA _1c无关。然而，运动的总持续时间（周）与 HbA _1c的 WMD 显着相关（元回归系数：0.01 [95% 置信区间：0.002-0.016]；R ² = 70.0%），并且该结果不包含显着异质性（P  > 0.05；I ²  = 14.7%）。

结论

运动干预可降低T2DM 患者的HbA _1c。此外，长时间的运动与 HbA _1c的增加有关，因此运动的影响可能在早期很明显，但结果表明单独长时间运动可能会增加 HbA _1c。