Structured exercise training associated with improved glycemic control
Patients with type 2 diabetes who engage in structured exercise training, including aerobic exercise and resistance training, and longer duration of weekly exercise had significantly lower HbA1c levels in a recent study.
Researchers conducted a systematic review and meta-analysis of randomized controlled clinical trials of at least 12 weeks that evaluated the relationship between a structured exercise program or physical activity advice and glycemic control. The analysis focused on 47 trials involving more than 8,500 participants.
Overall, data from 23 studies linked structured exercise training with a 0.67% reduction in HbA1c compared with control participants. In particular, results associated structured aerobic exercise with a 0.73% reduction; structured resistance training with a 0.57% reduction; and combined aerobic and resistance regimens with a 0.51% reduction in HbA1c levels.
In addition, structured exercise lasting more than 150 minutes per week was associated with HbA1c reductions of 0.89%. Shorter durations, however, were associated with a lower reduction (0.36%).
“This finding is important because the current guideline-recommended exercise duration is at least 150 minutes per week,” the researchers wrote.
Twenty-four studies that assessed the effect of physical activity advice on glucose levels linked physical activity advice interventions with a 0.43% decline in HbA1c levels compared with controls. Although physical activity advice alone had no effect on HbA1c levels, combined dietary and physical activity advice was associated with a 0.58% decrease.
In addition, the researchers found no evidence that high-intensity exercise is associated with greater declines in HbA1c.
Marco Pahor, MD, of the University of Florida, Gainesville, said additional information about the benefits and cost-effectiveness of structured exercising training is needed.
“The meta-analysis by Umpierre et al and cumulative evidence from a large number of randomized controlled trials conducted over the past few decades … provide solid evidence for public policymakers to consider structured exercise and physical activity programs as worthy of insurance reimbursement to promote health, especially in high-risk populations,” Pahor wrote in an accompanying editorial.
For more information:
- Pahor M. JAMA. 2011;305:1808-1809.
- Umpierre D. JAMA. 2011;305:1790-1799.
Disclosure: Several researchers report receiving research support and participating in advisory board meetings for various pharmaceutical companies.
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