Physical activity for diabetes-related depression: A systematic review and meta-analysis

Patients with diabetes have an increased risk of developing depression compared with non-diabetic individuals. We aimed to examine the utility of physical activity in the treatment of diabetes-related depression using a meta-analysis. Multiple databases were searched from inception to February 1, 2018. A random effects pooling model was used to examine the standardized mean difference and mean difference in the meta-analysis. A sensitivity analysis and meta-regression analyses were performed. Fourteen studies were included in a systematic review (1020 patients), while 13 were included in a meta-analysis (962 patients). Physical activity had a beneficial effect on depression as measured by Hedge's g (standardized mean difference = -0.59; 95% CI = -0.93 to -0.24). A sensitivity analysis indicated that the findings did not change in a meaningful way with the exclusion of studies with a high or unknown risk of bias in incomplete outcome data. Meta-regression analyses demonstrated that no covariate significantly influenced the main effect size. Physical activity had a significantly beneficial effect on depression as measured by the Beck Depression Inventory (mean difference = -2.90; 95% CI = -4.53 to -1.28). These findings suggest that physical activity may help ameliorate depression in patients with diabetes.