Metabolic effects of interventions to increase exercise in adults with type 2 diabetes
- 7 March 2007
- journal article
- research article
- Published by Springer Nature in Diabetologia
- Vol. 50 (5), 913-921
- https://doi.org/10.1007/s00125-007-0625-0
Abstract
The aim of this meta-analysis was to integrate the results of primary research testing the effect of diabetes self-management interventions that included recommendations to increase exercise on metabolic outcomes among adults with type 2 diabetes. Extensive literature searching strategies were used to identify published and unpublished intervention studies that measured glycated haemoglobin outcomes. Primary study results were coded. Fixed- and random-effects meta-analytic procedures included moderator analyses. Data were synthesised across 10,455 subjects from 103 research reports. The overall mean weighted effect size for two-group comparisons was 0.29 (higher mean for treatment than control). This effect size is consistent with a difference in HbA1c means of 0.45% (e.g. 7.38% for treatment subjects vs 7.83% for control subjects). For single-group studies, the overall mean weighted effect size was 0.32–0.34. Control group subjects experienced no improvement in metabolic control during participation in the studies. Interventions that targeted multiple health behaviours resulted in smaller effect size estimates (0.22) than interventions that focused only on exercise behaviours (0.45). Funded studies reported greater improvements in metabolic controls. Studies with a greater proportion of female subjects reported lower effect sizes. Baseline HbA1c and BMI were unrelated to metabolic outcomes. These findings suggest that self-management interventions that include exercise recommendations improve metabolic control, despite considerable heterogeneity in the magnitude of the intervention effect. Interventions that emphasise exercise may be especially effective in improving metabolic control. Primary research testing interventions in randomised trials to confirm causal relationships would be constructive.Keywords
This publication has 42 references indexed in Scilit:
- Evidence-based interventions to improve patient compliance with antihypertensive and lipid-lowering medicationsInternational Journal Of Clinical Practice, 2005
- Interventions for enhancing medication adherencePublished by Wiley ,2005
- The role of exercise for weight loss and maintenanceBest Practice & Research Clinical Gastroenterology, 2004
- The role of exercise for weight loss and maintenanceBest Practice & Research Clinical Gastroenterology, 2004
- Research methods: Managing primary study quality in meta‐analysesResearch in Nursing & Health, 2003
- Time course for changes in aerobic capacity and body composition in overweight men and women in response to long-term exercise: the Midwest Exercise Trial (MET)International Journal of Obesity, 2003
- How should meta‐regression analyses be undertaken and interpreted?Statistics in Medicine, 2002
- Individual patient‐ versus group‐level data meta‐regressions for the investigation of treatment effect modifiers: ecological bias rears its ugly headStatistics in Medicine, 2002
- Fixed- and random-effects models in meta-analysis.Psychological Methods, 1998
- Meta-analysis of the effects of educational and psychosocial interventions on management of diabetes mellitusJournal of Clinical Epidemiology, 1988