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The Effect of Physical Activity on Glycemic Variability in Patients With Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

PURPOSE: The effect of physical activity on glycemic variability remains controversial. This meta-analysis aimed to assess the overall effect of physical activity treatment on glycemic variability in patients with diabetes. METHODS: PubMed/MEDLINE, Embase, and Cochrane databases were searched for cl...

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Autores principales: Zhu, Xingyun, Zhao, Lina, Chen, Jing, Lin, Chu, Lv, Fang, Hu, Suiyuan, Cai, Xiaoling, Zhang, Li, Ji, Linong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8635769/
https://www.ncbi.nlm.nih.gov/pubmed/34867812
http://dx.doi.org/10.3389/fendo.2021.767152
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author Zhu, Xingyun
Zhao, Lina
Chen, Jing
Lin, Chu
Lv, Fang
Hu, Suiyuan
Cai, Xiaoling
Zhang, Li
Ji, Linong
author_facet Zhu, Xingyun
Zhao, Lina
Chen, Jing
Lin, Chu
Lv, Fang
Hu, Suiyuan
Cai, Xiaoling
Zhang, Li
Ji, Linong
author_sort Zhu, Xingyun
collection PubMed
description PURPOSE: The effect of physical activity on glycemic variability remains controversial. This meta-analysis aimed to assess the overall effect of physical activity treatment on glycemic variability in patients with diabetes. METHODS: PubMed/MEDLINE, Embase, and Cochrane databases were searched for clinical trials that conducted in patients with type 1 diabetes mellitus and type 2 diabetes mellitus with reports of the mean amplitude of glycemic excursion (MAGE), time in range (TIR), time above range (TAR), or time below range (TBR). Eligible trials were analyzed by fixed-effect model, random effect model, and meta-regression analysis accordingly. RESULTS: In total, thirteen trials were included. Compared with the control group, physical activity intervention was significantly associated with increased TIR (WMDs, 4.17%; 95% CI, 1.11 to 7.23%, P<0.01), decreased MAGE (WMDs, -0.68 mmol/L; 95% CI, -1.01 to -0.36 mmol/L, P<0.01) and decreased TAR (WMDs, -3.54%; 95% CI, -5.21 to -1.88%, P<0.01) in patients with diabetes, but showed insignificant effects on TBR. Patients with higher baseline BMI levels was associated with a greater decrease in MAGE (β=-0.392, 95% CI: -0.710, -0.074), and patients with lower baseline HbA1c levels was associated with a greater increase in TBR during physical activities (β=-0.903, 95% CI: -1.550, -0.255). CONCLUSION: Physical activity was associated with significantly decreased glycemic variability in patients with diabetes. Patients with higher BMI might benefit more from physical activity therapy in terms of a lower MAGE. Hypoglycemia associated with physical activity treatment still warranted caution, especially in patients with intensive glycemic control. SYSTEMATIC REVIEW REGISTRATION: PROSPERO [CRD42021259807].
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spelling pubmed-86357692021-12-02 The Effect of Physical Activity on Glycemic Variability in Patients With Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials Zhu, Xingyun Zhao, Lina Chen, Jing Lin, Chu Lv, Fang Hu, Suiyuan Cai, Xiaoling Zhang, Li Ji, Linong Front Endocrinol (Lausanne) Endocrinology PURPOSE: The effect of physical activity on glycemic variability remains controversial. This meta-analysis aimed to assess the overall effect of physical activity treatment on glycemic variability in patients with diabetes. METHODS: PubMed/MEDLINE, Embase, and Cochrane databases were searched for clinical trials that conducted in patients with type 1 diabetes mellitus and type 2 diabetes mellitus with reports of the mean amplitude of glycemic excursion (MAGE), time in range (TIR), time above range (TAR), or time below range (TBR). Eligible trials were analyzed by fixed-effect model, random effect model, and meta-regression analysis accordingly. RESULTS: In total, thirteen trials were included. Compared with the control group, physical activity intervention was significantly associated with increased TIR (WMDs, 4.17%; 95% CI, 1.11 to 7.23%, P<0.01), decreased MAGE (WMDs, -0.68 mmol/L; 95% CI, -1.01 to -0.36 mmol/L, P<0.01) and decreased TAR (WMDs, -3.54%; 95% CI, -5.21 to -1.88%, P<0.01) in patients with diabetes, but showed insignificant effects on TBR. Patients with higher baseline BMI levels was associated with a greater decrease in MAGE (β=-0.392, 95% CI: -0.710, -0.074), and patients with lower baseline HbA1c levels was associated with a greater increase in TBR during physical activities (β=-0.903, 95% CI: -1.550, -0.255). CONCLUSION: Physical activity was associated with significantly decreased glycemic variability in patients with diabetes. Patients with higher BMI might benefit more from physical activity therapy in terms of a lower MAGE. Hypoglycemia associated with physical activity treatment still warranted caution, especially in patients with intensive glycemic control. SYSTEMATIC REVIEW REGISTRATION: PROSPERO [CRD42021259807]. Frontiers Media S.A. 2021-11-17 /pmc/articles/PMC8635769/ /pubmed/34867812 http://dx.doi.org/10.3389/fendo.2021.767152 Text en Copyright © 2021 Zhu, Zhao, Chen, Lin, Lv, Hu, Cai, Zhang and Ji https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Endocrinology
Zhu, Xingyun
Zhao, Lina
Chen, Jing
Lin, Chu
Lv, Fang
Hu, Suiyuan
Cai, Xiaoling
Zhang, Li
Ji, Linong
The Effect of Physical Activity on Glycemic Variability in Patients With Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
title The Effect of Physical Activity on Glycemic Variability in Patients With Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
title_full The Effect of Physical Activity on Glycemic Variability in Patients With Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
title_fullStr The Effect of Physical Activity on Glycemic Variability in Patients With Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
title_full_unstemmed The Effect of Physical Activity on Glycemic Variability in Patients With Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
title_short The Effect of Physical Activity on Glycemic Variability in Patients With Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
title_sort effect of physical activity on glycemic variability in patients with diabetes: a systematic review and meta-analysis of randomized controlled trials
topic Endocrinology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8635769/
https://www.ncbi.nlm.nih.gov/pubmed/34867812
http://dx.doi.org/10.3389/fendo.2021.767152
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