Physical activity guidelines for adults with type 2 Diabetes: Systematic review
Eda Tonga1, Hannah Worboys2, Rachael A Evans3
1Diabetes Research Centre, College of Life Sciences, Department of Population Health Sciences, University of Leicester, Leicester, UK; NIHR Leicester Biomedical Research Centre, Leicester, UK.
Diabetes Research and Clinical Practice
|January 2, 2025
Summary
Physical activity guidelines for type 2 diabetes (T2D) consistently recommend aerobic exercise but lack focus on strength training. Methodological quality varied, highlighting a need for standardized development in future recommendations.
Area of Science:
- Endocrinology
- Sports Medicine
- Public Health
Background:
- Type 2 diabetes (T2D) management requires tailored physical activity strategies.
- Existing guidelines for T2D physical activity vary in quality and scope.
- Systematic review of current recommendations is needed to identify gaps and improve guidance.
Purpose of the Study:
- To systematically review and synthesize existing recommendations on physical activity for adults with type 2 diabetes (T2D).
- To evaluate the quality of physical activity guidelines for T2D.
- To identify disease-specific adaptations and limitations in current recommendations.
Main Methods:
- Systematic search of online databases for clinical practice guidelines (CPGs), statements, and recommendations.
- Screening of guidelines based on eligibility criteria by two independent authors.
- Extraction of FITT (Frequency, Intensity, Time, Type) parameters and disease-specific precautions.
- Assessment of CPG methodological quality using the AGREE II instrument.
Main Results:
- Fifteen guidelines were included in the review.
- Three of nine evaluated CPGs were rated high quality; others were moderate to low.
- Predominant recommendation: at least 150 minutes of moderate aerobic exercise weekly.
- T2D adaptations focused on glucose control, diet, foot care, weather, sedentary behavior, neuropathy, and retinopathy.
Conclusions:
- Guidelines emphasize aerobic exercise but underemphasize strength and flexibility training for T2D.
- Significant limitations in methodological quality and reporting were observed, particularly in stakeholder involvement and applicability.
- Future T2D physical activity guidelines should adopt standardized FITT frameworks and robust development methods for improved usability.
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