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Effect of Exercise-Based Interventions on HbA1c in Adults with Type 1 Diabetes: A Systematic Review and Meta-Analysis
Fatemeh Malakoutinia1, Azadeh Ghaheri2, Samira Vesali2
1Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khorramabad, Iran.
Objective:
This study intends to determine whether exercise-based interventions improve haemoglobin A1c (HbA1c) levels in adults with type 1 diabetes (T1D) and examines how different types of exercise influence this association.
Materials And Methods:
A search of the appropriate electronic databases revealed 18 eligible studies from initial 685 records. The effect of exercise training on HbA1c was examined in two parts: i. Exercise training intervention compared to a T1D control group (between-group analysis) and ii. Pre/post comparison of exercise training intervention on T1D patients (within-group analysis).
Results:
The between-group results showed that exercise training had a statistically significant reduction in HbA1c [mean difference (MD), confidence interval (CI)]: -0.39 (-0.64, -0.15), P=0.002, I2=0%). Subgroup analysis based on the types of exercise training showed a statistically significant effect of high-intensity interval training (HIIT) on HbA1c levels in both the within-group analyses [MD: -0.24 (-0.45, -0.02), P=0.03, I2=0%] and between-group analyses [MD: -0.39 (-0.64, -0.15), P=0.002, I2=0%].
Conclusion:
The meta-analysis and meta-regression results suggest that HIIT may be a supportive intervention in T1D patients; however, there was insufficient evidence to confirm these findings. Data from more randomised controlled trials (RCTs) are needed to compare the effect of different types of exercise on HbA1c levels in T1D patients [registration: PROSPERO (CRD42023414580)].
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