Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2019 Jan 7;16(1):140.
doi: 10.3390/ijerph16010140.

Resistance Exercise Intensity is Correlated with Attenuation of HbA1c and Insulin in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis

Yubo Liu  1 , Weibing Ye  2 , Qian Chen  3 , Yong Zhang  4 , Chia-Hua Kuo  5 , Mallikarjuna Korivi  6
Affiliations
Meta-Analysis

Resistance Exercise Intensity is Correlated with Attenuation of HbA1c and Insulin in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis

Yubo Liu et al. Int J Environ Res Public Health. .

Abstract

We investigated the influence of resistance exercise (RE) with different intensities on HbA1c, insulin and blood glucose levels in patients with type 2 diabetes (T2D). Diabetes trials that compared RE group with a control were included in meta-analysis. Exercise intensities were categorized into low-to-moderate-intensity and high-intensity subgroups. Intensity effect on glycemic control was determined by meta-regression analysis, and risk-of-bias was assessed using Cochrane Collaboration tool. 24 trials met the inclusion criteria, comprised of 962 patients of exercise (n = 491) and control (n = 471). Meta-regression analysis showed decreased HbA1c (p = 0.006) and insulin (p = 0.015) after RE was correlated with intensity. Subgroup analysis revealed decreased HbA1c was greater with high intensity (-0.61; 95% CI -0.90, -0.33) than low-to-moderate intensity (-0.23; 95% CI -0.41, -0.05). Insulin levels were significantly decreased only with high intensity (-4.60; 95% CI -7.53, -1.67), not with low-to-moderate intensity (0.07; 95% CI -3.28, 3.42). Notably, values between the subgroups were statistically significant for both HbA1c (p = 0.03) and insulin (p = 0.04), indicative of profound benefits of high-intensity RE. Pooled outcomes of 15 trials showed only a decreased trend in blood glucose with RE (p = 0.09), and this tendency was not associated with intensity. Our meta-analysis provides additional evidence that high-intensity RE has greater beneficial effects than low-to-moderate-intensity in attenuation of HbA1c and insulin in T2D patients.

Keywords: diabetes; glycosylated hemoglobin; insulin; meta-regression; strength training.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) flow diagram of study selection.
Figure 2
Figure 2
Forest plot of HbA1c changes with different intensities of resistance exercise in patients with type 2 diabetes. SD, standard deviation; IV, inverse variation; CI, confidence internal; df, degrees of freedom.
Figure 3
Figure 3
Forest plot of insulin changes with different intensities of resistance exercise in patients with type 2 diabetes. SD, standard deviation; IV, inverse variation; CI, confidence internal; df, degrees of freedom.
Figure 4
Figure 4
Pooled outcome of changes in blood glucose levels after resistance exercise in patients with type 2 diabetes. SD, standard deviation; IV, inverse variation; CI, confidence internal; df, degrees of freedom.
Figure 5
Figure 5
Summary of the risk of bias for the trials included in this meta-analysis. Green indicates low risk of bias, yellow indicates unclear, and red indicates high risk of bias.
See this image and copyright information in PMC

References

    1. Gillies C.L., Abrams K.R., Lambert P.C., Cooper N.J., Sutton A.J., Hsu R.T., Khunti K. Pharmacological and lifestyle interventions to prevent or delay type 2 diabetes in people with impaired glucose tolerance: Systematic review and meta-analysis. BMJ. 2007;334:299. doi: 10.1136/bmj.39063.689375.55. - DOI - PMC - PubMed
    1. Lee J., Kim D., Kim C. Resistance training for glycemic control, muscular strength, and lean body mass in old type 2 diabetic patients: A meta-analysis. Diabetes Ther. 2017;8:459–473. doi: 10.1007/s13300-017-0258-3. - DOI - PMC - PubMed
    1. Pesta D.H., Goncalves R.L., Madiraju A.K., Strasser B., Sparks L.M. Resistance training to improve type 2 diabetes: Working toward a prescription for the future. Nutr. Metab. 2017;14:24. doi: 10.1186/s12986-017-0173-7. - DOI - PMC - PubMed
    1. Rau C.-S., Wu S.-C., Chen Y.-C., Chien P.-C., Hsieh H.-Y., Kuo P.-J., Hsieh C.-H. Mortality rate associated with admission hyperglycemia in traumatic femoral fracture patients is greater than non-diabetic normoglycemic patients but not diabetic normoglycemic patients. Int. J. Environ. Res. Public Health. 2017;15:28. doi: 10.3390/ijerph15010028. - DOI - PMC - PubMed
    1. International Diabetes Federation . IDF Diabetes Atlas. 8th ed. International Diabetes Federation; Brussels, Belgium: 2017.

Publication types