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Optimal exercise dose for glycemic control in prediabetes across different exercise types.

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High-intensity interval training (HIIT) offers the most significant reduction in HbA1c for prediabetes. Optimal exercise prescriptions should consider body mass index (BMI) and exercise type for personalized glycemic control.

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Area of Science:

  • Exercise Science
  • Metabolic Health
  • Clinical Endocrinology

Background:

  • Prediabetes affects a significant portion of the population, increasing cardiovascular and diabetes risks.
  • Glycemic control in prediabetes is crucial for preventing progression to type 2 diabetes.
  • Exercise is a cornerstone of prediabetes management, but optimal strategies require clarification.

Purpose of the Study:

  • To determine the optimal exercise modality and dose for reducing HbA1c in prediabetes.
  • To investigate the influence of baseline Body Mass Index (BMI) on exercise effectiveness.
  • To conduct a comprehensive meta-analysis of randomized controlled trials (RCTs) on exercise interventions for prediabetes.

Main Methods:

  • Systematic search of six databases for relevant RCTs.
  • Pairwise, network, and dose-response meta-analyses were performed.
  • Included 39 RCTs with 3421 participants examining various exercise modalities and doses.

Main Results:

  • All exercise modalities significantly reduced HbA1c compared to controls.
  • High-intensity interval training (HIIT) demonstrated the largest HbA1c reduction.
  • An optimal weekly exercise dose of 850 METs·min/week was identified, with minimum effective doses varying by BMI and exercise type.

Conclusions:

  • Exercise effectively improves HbA1c in prediabetes via a nonlinear dose-response relationship.
  • Individualized exercise prescriptions, stratified by BMI and tailored to exercise modality, are recommended for optimizing glycemic control.
  • HIIT appears most potent, but other modalities also contribute to HbA1c reduction.