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

PurposeThe 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.MethodsPubMed/MEDLINE, Embase, and Cochrane databases were searched for clinica...

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Autores principales: Xingyun Zhu, Lina Zhao, Jing Chen, Chu Lin, Fang Lv, Suiyuan Hu, Xiaoling Cai, Li Zhang, Linong Ji
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Publicado: Frontiers Media S.A. 2021
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spelling oai:doaj.org-article:e6aff40237bc4bb9b7b282777c498c532021-11-17T06:12:53ZThe Effect of Physical Activity on Glycemic Variability in Patients With Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials1664-239210.3389/fendo.2021.767152https://doaj.org/article/e6aff40237bc4bb9b7b282777c498c532021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fendo.2021.767152/fullhttps://doaj.org/toc/1664-2392PurposeThe 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.MethodsPubMed/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.ResultsIn 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).ConclusionPhysical 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 RegistrationPROSPERO [CRD42021259807].Xingyun ZhuLina ZhaoJing ChenChu LinFang LvSuiyuan HuXiaoling CaiLi ZhangLinong JiFrontiers Media S.A.articlephysical activityglycemic variabilityglycemic controldiabetescontinuous glucose monitoringDiseases of the endocrine glands. Clinical endocrinologyRC648-665ENFrontiers in Endocrinology, Vol 12 (2021)
institution DOAJ
collection DOAJ
language EN
topic physical activity
glycemic variability
glycemic control
diabetes
continuous glucose monitoring
Diseases of the endocrine glands. Clinical endocrinology
RC648-665
spellingShingle physical activity
glycemic variability
glycemic control
diabetes
continuous glucose monitoring
Diseases of the endocrine glands. Clinical endocrinology
RC648-665
Xingyun Zhu
Lina Zhao
Jing Chen
Chu Lin
Fang Lv
Suiyuan Hu
Xiaoling Cai
Li Zhang
Linong Ji
The Effect of Physical Activity on Glycemic Variability in Patients With Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
description PurposeThe 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.MethodsPubMed/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.ResultsIn 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).ConclusionPhysical 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 RegistrationPROSPERO [CRD42021259807].
format article
author Xingyun Zhu
Lina Zhao
Jing Chen
Chu Lin
Fang Lv
Suiyuan Hu
Xiaoling Cai
Li Zhang
Linong Ji
author_facet Xingyun Zhu
Lina Zhao
Jing Chen
Chu Lin
Fang Lv
Suiyuan Hu
Xiaoling Cai
Li Zhang
Linong Ji
author_sort Xingyun Zhu
title 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_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_sort effect of physical activity on glycemic variability in patients with diabetes: a systematic review and meta-analysis of randomized controlled trials
publisher Frontiers Media S.A.
publishDate 2021
url https://doaj.org/article/e6aff40237bc4bb9b7b282777c498c53
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