2型糖尿病患者における血糖コントロールのための食事併用運動介入の効果:ランダム化比較試験のメタアナリシス
Xiaoyi Huang1,2, Guihao Huang3, Man Jiang2
1Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macau, China.
Introduction:
To systematically analyze the effect of diet combined with exercise intervention on blood glucose control in patients with type 2 diabetes.
Evidence Acquisition:
Six databases including PubMed, The Cochrane Library, Web of Science, EMBASE, MEDLINE and CNKI were searched from establishment to September 2024. Randomized Control Trial (RCT) articles that met the inclusion and exclusion criteria were screened. Meta-analysis was performed using Review Manager 5.3 software. The quality of the literature was assessed using the Cochrane Handbook of Systematic Reviews. Subgroup analysis and sensitivity analysis were used to find the source of heterogeneity.
Evidence Synthesis:
Sixteen studies were included, with a total of 7212 patients with type 2 diabetes. There were 3678 cases in the intervention group and 3534 cases in the control group. The results of meta-analysis showed that dietary combined exercise intervention significantly improved fasting blood glucose (MD=-0.39, 95% CI: -0.72~-0.06, P=0.02) and 2-hour postprandial blood glucose (MD=-1.67, 95% CI: -3.62~0.27, P=0.09), glycosylated hemoglobin, HbA1c (MD=-0.49, 95% CI: -1.27~-0.33, P<0.001), body weight (MD=-2.47, 95% CI: -4.82~-0.13, P=0.04), body mass (MD=-3.64, 95% CI: -4.07~-3.21, P<0.001), SBP (MD=-2.1, 95% CI: -4.30~0.28, P=0.09), DBP (MD=-0.93, 95% CI: -1.88~0.02, P=0.05), total cholesterol (MD=17, 95% CI: -0.02~0.35, P=0.07), triglyceride (MD=-0.08, 95% CI: -0.15~-0.01, P=0.03), QOL (MD=3.83, 95% CI: 0.69~6.98, P=0.02). Body Mass Index (BMI) (MD=-0.4, 95% CI: -0.32~0.24, P=0.79), waist circumference (MD=-1.4, 95% CI: -4.94~1.25, P=0.24), HDL (MD=-0.02, 95% CI: -0.08~0.03, P=0.43), LDL (MD=12, 95% CI: -0.37~0.61, P=0.63) may be due to insufficient patient compliance, short intervention time, or insufficient study sample size to detect significant improvement.
Conclusions:
Diet combined with exercise intervention has significant effect on blood glucose control in patients with type 2 diabetes, and can significantly reduce HbA1c, fasting blood glucose, 2 h postprandial blood glucose, body weight, body mass, total cholesterol, triglyceride, SBP, DBP and QOL. Therefore, it is recommended that exercise combined with dietary intervention for at least 3 to 6 months can better improve the blood glucose indicators in patients with type 2 diabetes.
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