Abstract
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].
Highlights
Physical activity was considered as an easy and economical way to improve overall well-being [1, 2]
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)
Compared with the control group, physical activity intervention was significantly associated with increased TIR (WMDs, 4.17%; 95% confidence intervals (CI), 1.11 to 7.23%, P
Summary
Physical activity was considered as an easy and economical way to improve overall well-being [1, 2]. Physical activity was proved to improve glycemic control, manifested as reducing hemoglobin A1c (HbA1c) and fasting plasma glucose (FPG) [3,4,5,6]. Recent studies indicated that even light physical activities breaking the prolonged sitting could bring metabolic benefits to patients with diabetes [7, 8]. The efficacy of physical activity treatment on the improvement of HbA1c could only indicate the reduction in mean glucose level. Whether taking physical activities will expose diabetic patients to an increased risk of hyperglycemia or hypoglycemia is still under great debate [4, 5, 12,13,14,15,16,17]. Since emerging evidence has built a positive relationship between glycemic variability and diabetes complications, the effect of physical activity on glycemic variability increasingly attracts public attention [18,19,20,21]
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