The Effectiveness of Clinician-Led Community-Based Group Exercise Interventions on Health Outcomes in Adults with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis.

Liam White, Morwenna Kirwan, Vita Christie, Lauren Hurst, Kylie Gwynne

Journal: International journal of environmental research and public health 2024;21(5):601

PMID: 38791815

Plain Language Summary

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Physical activity, alongside nutritional and medical therapies, is critical for managing type 2 diabetes mellitus. Exercise, a specific category of physical activity, involves activities that improve strength, endurance, agility, balance, and flexibility, all of which are beneficial for type 2 diabetes mellitus patients. The aim of this study was to investigate the combined effects of clinician-led and community-based group exercise interventions for adults with type 2 diabetes mellitus. This study was a systematic review and meta-analysis of eight peer-reviewed studies with 938 participants. Results showed that: - physical fitness outcomes (assessed through tests like the six-minute walk test) showed improvements in all five relevant studies. - anthropometric outcomes (waist circumference, diastolic blood pressure) improved in seven studies, while other measures (body mass index, systolic blood pressure, weight, resting heart rate) remained unchanged. - haematological outcomes (fasting blood glucose, triglycerides, total cholesterol) improved significantly, but LDL and HDL cholesterol levels remained unaffected. Authors concluded that both community-based and clinician-led group exercise interventions can positively influence health outcomes in individuals with type 2 diabetes mellitus.

Abstract

This systematic review and meta-analysis evaluated the combined effects of clinician-led and community-based group exercise interventions on a range of health outcomes in adults with type 2 diabetes mellitus. Our literature search spanned Medline, Scopus, PubMed, Embase, and CINAHL databases, focusing on peer-reviewed studies published between January 2003 and January 2023. We included studies involving participants aged 18 years and older and articles published in English, resulting in a dataset of eight studies with 938 participants. Spanning eight peer-reviewed studies with 938 participants, the analysis focused on the interventions' impact on glycemic control, physical fitness, and anthropometric and hematological measurements. Outcomes related to physical fitness, assessed through the six-minute walk test, the 30 s sit-to-stand test, and the chair sit-and-reach test, were extracted from five studies, all of which reported improvements. Anthropometric outcomes from seven studies highlighted positive changes in waist circumference and diastolic blood pressure; however, measures such as body mass index, systolic blood pressure, weight, and resting heart rate did not exhibit significant changes. Hematological outcomes, reviewed in four studies, showed significant improvements in fasting blood glucose, triglycerides, and total cholesterol, with glycemic control evidenced by reductions in HbA1c levels, yet LDL and HDL cholesterol levels remained unaffected. Ten of the fifteen outcome measures assessed showed significant enhancement, indicating that the intervention strategies implemented may offer substantial health benefits for managing key type 2 diabetes mellitus-related health parameters. These findings in combination with further research, could inform the refinement of physical activity guidelines for individuals with type 2 diabetes mellitus, advocating for supervised group exercise in community settings.

Address: Faculty of Medicine, Health and Human Sciences, Macquarie University, Talavera Road, North Ryde, NSW 2109, Australia.; Djurali Centre for Aboriginal and Torres Strait Islander Health Research, Heart Research Institute, Eliza Street, Newtown, NSW 2042, Australia.; DVC Indigenous Office, University of New South Wales, High Street, Sydney, NSW 2052, Australia.
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