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01-12-2021 | Diabetes | Original Article

The relationship between the level of exercise and hemoglobin A₁c in patients with type 2 diabetes mellitus: a systematic review and meta-analysis

Authors: Yutaka Igarashi, Nobuhiko Akazawa, Seiji Maeda

Published in: Endocrine | Issue 3/2021

Abstract

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.

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Title: The relationship between the level of exercise and hemoglobin A1c in patients with type 2 diabetes mellitus: a systematic review and meta-analysis
Authors: Yutaka Igarashi
Nobuhiko Akazawa
Seiji Maeda
Publication date: 01-12-2021
Publisher: Springer US
Keywords: Diabetes
Type 2 Diabetes
Published in: Endocrine / Issue 3/2021
Print ISSN: 1355-008X
Electronic ISSN: 1559-0100
DOI: https://doi.org/10.1007/s12020-021-02817-8

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