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. 2024 Feb 19:15:1308959.
doi: 10.3389/fendo.2024.1308959. eCollection 2024.

Exercise training modalities in prediabetes: a systematic review and network meta-analysis

Hang Zhang  1 , Yuting Guo  1 , Guangshun Hua  1 , Chenyang Guo  1 , Simiao Gong  2 , Min Li  1 , Yan Yang  3
Affiliations

Exercise training modalities in prediabetes: a systematic review and network meta-analysis

Hang Zhang et al. Front Endocrinol (Lausanne). .

Abstract

Background: Lifestyle modification based on exercise intervention is still the primary way to delay or reverse the development of diabetes in patients with prediabetes. However, there are still challenges in setting up a detailed exercise prescription for people with prediabetes. This study mainly ranks exercise prescriptions by comparing the improvement of glucose and lipid metabolism and the level of weight loss in patients.

Method: All studies on exercise intervention in prediabetes were identified by searching five electronic databases. Risk assessment and meta-analysis were performed on eligible studies.

Results: Twenty-four studies involving 1946 patients with prediabetes and seven exercise intervention models were included in the final analysis. The meta-analysis showed that exercise of any type was more effective for glycemic control in prediabetes than no exercise. However, the changes in blood glucose were moderate. In prediabetes, combining moderate-intensity aerobic exercise with low-to moderate-load resistance training showed the most significant improvements in glycosylated hemoglobin (HbA1c), body mass index (BMI), body weight (BW), total cholesterol (TC), and low-density lipoprotein cholesterol (LDL) (P-score=0.82; 0.70; 0.87; 1; 0.99), low-to moderate-load resistance training showed the most significant improvements in fasting blood glucose (FBG) (P-score=0.98), the vigorous-intensity aerobic exercise showed the most significant improvements in 2-hour post-meal blood glucose (2hPG) and systolic blood pressure (SBP) (P-score=0.79; 0.78), and moderate-intensity aerobic exercise showed the most significant improvements in diastolic blood pressure (DBP) (P-score=0.78).

Conclusion: In summary, moderate-intensity aerobic exercise, low-to moderate-load resistance training and the combination of both have beneficial effects on glycemic control, weight loss, and cardiovascular health in patients with prediabetes. These findings provide valuable guidance for rehabilitation clinicians and patients alike to follow.

Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD 42021284922.

Keywords: cardiovascular risk factors; exercise; glycemic control; network meta-analysis; prediabetic state; weight loss.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
PRISMA Flow diagram of the search process for studies.
Figure 2
Figure 2
Summary of the risk of bias assessment in the individual domains of the included studies.
Figure 3
Figure 3
Network plot of FBG.
See this image and copyright information in PMC

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