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Does Exercise Improve Glycaemic Control in Type 1 Diabetes? A Systematic Review and Meta-Analysis

Author

Listed:
  • Amy Kennedy
  • Krishnarajah Nirantharakumar
  • Myriam Chimen
  • Terence T Pang
  • Karla Hemming
  • Rob C Andrews
  • Parth Narendran

Abstract

Objective: Whilst regular exercise is advocated for people with type 1 diabetes, the benefits of this therapy are poorly delineated. Our objective was to review the evidence for a glycaemic benefit of exercise in type 1 diabetes. Research Design and Methods: Electronic database searches were carried out in MEDLINE, Embase, Cochrane’s Controlled Trials Register and SPORTDiscus. In addition, we searched for as yet unpublished but completed trials. Glycaemic benefit was defined as an improvement in glycosylated haemoglobin (HbA1c). Both randomised and non-randomised controlled trials were included. Results: Thirteen studies were identified in the systematic review. Meta-analysis of twelve of these (including 452 patients) demonstrated an HbA1c reduction but this was not statistically significant (standardised mean difference (SMD) −0.25; 95% CI, −0.59 to 0.09). Conclusions: This meta-analysis does not reveal evidence for a glycaemic benefit of exercise as measured by HbA1c. Reasons for this finding could include increased calorie intake, insulin dose reductions around the time of exercise or lack of power. We also suggest that HbA1c may not be a sensitive indicator of glycaemic control, and that improvement in glycaemic variability may not be reflected in this measure. Exercise does however have other proven benefits in type 1 diabetes, and remains an important part of its management.

Suggested Citation

  • Amy Kennedy & Krishnarajah Nirantharakumar & Myriam Chimen & Terence T Pang & Karla Hemming & Rob C Andrews & Parth Narendran, 2013. "Does Exercise Improve Glycaemic Control in Type 1 Diabetes? A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 8(3), pages 1-10, March.
    • Handle: RePEc:plo:pone00:0058861
    DOI: 10.1371/journal.pone.0058861
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    References listed on IDEAS

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    1. Ching‐Hsiang Wong & Yi‐Chien Chiang & Jackson Pui Man Wai & Fu‐Sung Lo & Chao‐Hsing Yeh & Shih‐Chi Chung & Chi‐Wen Chang, 2011. "Effects of a home‐based aerobic exercise programme in children with type 1 diabetes mellitus," Journal of Clinical Nursing, John Wiley & Sons, vol. 20(5‐6), pages 681-691, March.
    2. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
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    1. Mhairi Patience & Xanne Janssen & Alison Kirk & Stephanie McCrory & Eilidh Russell & William Hodgson & Megan Crawford, 2023. "24-Hour Movement Behaviours (Physical Activity, Sedentary Behaviour and Sleep) Association with Glycaemic Control and Psychosocial Outcomes in Adolescents with Type 1 Diabetes: A Systematic Review of ," IJERPH, MDPI, vol. 20(5), pages 1-18, February.
    2. Maria Pia Francescato & Giuliana Stel & Elisabetta Stenner & Mario Geat, 2015. "Prolonged Exercise in Type 1 Diabetes: Performance of a Customizable Algorithm to Estimate the Carbohydrate Supplements to Minimize Glycemic Imbalances," PLOS ONE, Public Library of Science, vol. 10(4), pages 1-14, April.

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