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Effectiveness of Exercise Intervention in Reducing Body Weight and Glycosylated Hemoglobin Levels in Patients with Type 2 Diabetes Mellitus in Korea: A Systematic Review and Meta-Analysis |
Ji-Eun Jang ,1,2 Yongin Cho , 3 Byung Wan Lee , 3 Ein-Soon Shin,4 and Sun Hee Lee5 |
1Department of Medical Science, The Graduate School of Ewha Womans University, Seoul, Korea. |
2Research Institute for Healthcare Policy, Korean Medical Association, Seoul, Korea. |
3Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. |
4Research Agency for Clinical Practice Guidelines, Research Center, Korean Academy of Medical Sciences, Seoul, Korea. |
5Department of Preventive Medicine, Ewha Womans University School of Medicine, Seoul, Korea. |
Corresponding author: Yongin Cho. Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea. Email: choyorin@yuhs.ac Corresponding author: Byung Wan Lee. Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea. Email: bwanlee@yuhs.ac
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Received April 13, 2018; Accepted August 16, 2018.
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This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Abstract
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Background
This study aimed to assess the effectiveness of exercise intervention in reducing body weight and glycosylated hemoglobin (HbA1c) level in patients with type 2 diabetes mellitus (T2DM) in Korea.
Methods
Cochrane, PubMed, Embase, KoreaMed, KMbase, NDSL, KCI, RISS, and DBpia databases were used to search randomized controlled trials and controlled clinical trials that compared exercise with non-exercise intervention among patients with non-insulin-treated T2DM in Korea. The effectiveness of exercise intervention was estimated by the mean difference in body weight changes and HbA1c level. Weighted mean difference (WMD) with its corresponding 95% confidence interval (CI) was used as the effect size. The pooled mean differences of outcomes were calculated using a random-effects model.
Results
We identified 7,692 studies through literature search and selected 23 articles (723 participants). Compared with the control group, exercise intervention (17 studies) was associated with a significant decline in HbA1c level (WMD, −0.58%; 95% CI, −0.89 to −0.27; I2=73%). Although no significant effectiveness on body weight was observed, eight aerobic training studies showed a significant reduction in body weight (WMD, −2.25 kg; 95% CI, −4.36 to −0.13; I2=17%) in the subgroup analysis.
Conclusion
Exercise significantly improves glycemic control; however, it does not significantly reduce body weight. Aerobic training can be beneficial for patients with non-insulin-treated T2DM in Korea.
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Keywords:
Body weight; Exercise therapy; Glycated hemoglobin A; Meta-analysis; Review
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