Clinical outcomes to exercise training in type 1 diabetes: A systematic review and meta-analysis. (May 2018)

• Record Type: Journal Article
• Authors: Ostman, C.; Jewiss, D.; King, N.; Smart, N.A.
• Is Part Of: Diabetes research and clinical practice. Volume 139(2018)
• Page Start: 380
• Page End: 391
• Publication Date: 2018-05
• Subjects: BMI body mass index -- CI confidence interval -- HDL high density lipoproteins -- LDL low density lipoproteins -- HbA1C% glycosylated hemoglobin -- % HRmax heart rate peak -- % VO2 Peak percentage of peak oxygen uptake -- MD mean difference; Exercise training -- Meta-analysis -- Type I diabetes; Diabetes -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462
• DOI: 10.1016/j.diabres.2017.11.036
• Languages: English
• ISSNs: 0168-8227

Abstract

Highlights: Meta-analysis investigating exercise training in type 1 diabetes. Exercise reduced daily insulin, BMI, peak VO2 and resting heart rate. Exercise also reduced resting systolic blood pressure, LDL and triglycerides. No effect on HbA1C%, Fasting Blood Glucose, body mass or HDL. This could stimulate development of novel treatment regimes for type 1 diabetes. Abstract: Aims: To establish the relationship between exercise training and clinical outcomes in people with type I diabetes. Methods: Studies were identified through a MEDLINE search strategy, Cochrane Controlled Trials Registry, CINAHL, SPORTDiscus and Science Citation Index. The search strategy included a mix of key concepts related to trials of exercise training in people with type 1 diabetes; glycaemic control. Searches were limited to prospective randomized or controlled trials of exercise training in humans with type 1 diabetes lasting 12 weeks or more. Results: In exercised adults there were significant improvements in body mass Mean Difference (MD): −2.20 kg, 95% Confidence Interval (CI) −3.79–0.61, p = .007; body mass index (BMI) MD: −0.39 kg/m 2, 95% CI −0.75–0.02, p = .04; Peak VO2 MD: 4.08 ml/kg/min, 95% CI −2.18–5.98, p < .0001; and, low-density lipoprotein cholesterol (LDL) MD: −0.21 mmol/L, 95% CI −0.33–0.08, p = .002. In exercised children there were significant improvements in insulin dose MD: −0.23 IU/kg, 95% CI −0.37–0.09, p = .002; waist circumference MD: −5.40 cm, 95% CI −8.45 to −2.35, p = .0005; LDL MD: −0.31 mmol/L, 95% CI −0.55 to −0.06, p = .02; and, triglycerides MD: −0.21 mmol/L, 95% CI −0.42 to −0.01, p = .04. There were no significant changes in glycosylated haemoglobin (HbA1C%), fasting blood glucose, resting heart rate, resting systolic blood pressure or high density lipoproteins in either group. Conclusions: Exercise training improves some markers of type 1 diabetes severity; particularly body mass, BMI, Peak VO2 and LDL in adults and insulin dose, waist circumference, LDL and triglycerides in children.