Table 1.
Characteristics of the included studies.
| Study, Year (Ref.) |
Participants (Age, Simple Size, Diabetes Duration) | Intervention | Outcome Measures | PEDro Score | |||
|---|---|---|---|---|---|---|---|
| N | Mean Age ± SD/Age Range (Years) | Duration of T1D (Years) | (Exercise Frequency, Intensity, Type of Exercise, Time Duration per Session) | Program Duration | |||
| Aouadi et al. 2011 a [26] | EG: 11 CG: 11 |
EG: 12.2 ± 1.5; CG: 12.9 ± 1.3 |
EG: 3.6 ± 0.8; CG: 3.2 ± 0.54 |
EG: 2×/week, 50–55% HRmax at weeks 1–2; 55–60% HRmax at weeks 3–4; 60–65% HRmax at weeks 5–24; 10–15 min WU and CD + 40–50 min aerobic exercise CG: continued with normal PA behavior |
24 weeks | BMI  in both groups HDL-C ↑ significantly in EG Triglyceride ↓ significantly in EG Daily insulin dosage ↓ in EG |
6 |
| Aouadi et al. 2011 b [26] | EG: 11 CG: 11 |
EG: 13.5 ± 0.8; CG: 12.9 ± 1.3 |
EG: 4.1 ± 1.3; CG: 3.2 ± 0.54 |
EG: 4×/week, 50–55% HRmax at weeks 1–2; 55–60% HRmax at weeks 3–4; 60–65% HRmax at weeks 5–24; 10–15 min WU and CD + 40–50 min aerobic exercise CG: continued with normal PA behavior |
24 weeks | BMI in EG, CG HbA1c ↓ significantly in EG HDL-C ↑ significantly in EG Triglycerides ↓ significantly in EG LDL-C ↓ significantly in EG Daily insulin dosage ↓ in EG |
6 |
| Brazeau et al. 2014 [27] | EG: 23 (12 F; 11 M) CG: 25 (14 F; 11 M) |
EG: 45.1 ± 14.5; CG: 44.2 ± 12.5 |
EG: 20.3 ± 12.9; CG: 24.4 ± 13.6 |
EG: leaflet on PA promotion with exercise 1×/week, 60 min of various activities (endurance, resistance, flexibility) + 30 min of counselling (PA and introduced glycemic management related to PA) CG: received leaflet on PA promotion and carried out normal PA |
12 weeks | Weight ↓ significantly in EG BMI in both groups HbA1c in both groups VO2peak ↑ significantly in EG SBP ↓ significantly in EG DBP ↓ significantly in EG |
7 |
| Campaigne et al. 1984 [24] | EG: 9 CG: 10 |
EG: 9.0 ± 0.47 (SEM); CG: 8.5 ± 0.57 (SEM) |
EG: 5.1 ± 0.95 (SEM); CG: 3.89 ± 0.70 (SEM) |
EG: 3×/week, HR ≥ 160 bpm, 30 min of vigorous exercise (running, movement to music), supervised aerobic exercise CG: continued with normal PA behavior |
12 weeks | Weight ↑ significantly in EG Weight ↑ in CG FBG ↓ significantly in EG, significantly lower than CG HbA1c ↓ significantly in EG, significantly lower than CG Daily insulin dosage in both groups VO2peak ↑ significantly in EG |
5 |
| Campaigne et al. 1985 [28] | EG: 9 (6 F; 3 M) CG: 5 (3 M; 2 F) |
EG: 16.0 ± 1 (SEM); CG: 15 ± 0.4 (SEM) |
EG: 6.6 ± 1.1 (SEM); CG: 6.2 ± 1.1 (SEM); |
EG: 3×/week, HR > 160 bpm intensity, 10 min WU + 25 min aerobic movement to music + 10 min CD, supervised aerobic exercise CG: continued with normal PA behavior |
12 weeks | Weight in both groups Lean body mass ↑ in EG, in CG VO2peak ↑ significantly in EG, in CG LDL-C ↓ significantly in EG, in CG Total cholesterol, triglyceride, HDL-C in both groups HbA1 in both groups Daily insulin dosage in both groups |
5 |
| D’ hooge et al. 2011 [29] | EG: 8 CG: 8 |
EG: 14.1 (10.1–16.8); CG: 13.2 (10.1–15.3) |
EG: 5.4 (3.4–7.3); CG: 5.3 (2.9–5.9) |
EG: 2×/week, 60% HRR increased to 70% HRR after 6 weeks, 75% HRR after 12 weeks; 5 min WU + 30 min strength training (upper limbs, lower limbs, and abdominal muscles, 10 min each) + 30 min aerobic training (cycling, running and stepping, 10 min each) + 5 min CD. Strength training: first 12 sessions: 2 sets of 15 reps at 20 RM; next 12 sessions: 2 sets of 12 reps at 17 RM; final 8 weeks: 3 sets of 10 reps at 12 RM; 60 s rest between 2 sets; supervised aerobic exercise and strength training CG: normal activity |
20 weeks | Weight in both groups BMI in both groups VO2peak in both groups Muscle fatigue score, number of sit to stand, upper and lower limb strength, 6 min walking distance ↑ significantly in EG HbA1c in both groups FBG in both groups Daily insulin dosage ↓ significantly in EG, in CG Quality of life (SF-36) in both groups |
7 |
| Dahl-Jorgensen et al. 1980 [30] | EG: 14 CG: 8 |
9–15 | 5 | EG: 2×/week, 60 min; supervised exercise; and supplemented by a weekly home exercise experience CG: did not participate in any standardized exercise regime |
20 weeks | VO2peak
in both groups Daily insulin dosage in both groups HbA1c ↓ significantly in EG, in CG |
5 |
| Durak et al. 1990(crossover) [31] | EG: 8 CG: 8 |
EG: 31 ± 3.5 CG: 31 ± 3.5 |
EG: 12.3 ± 9.8 CG: 12.3 ± 9.8 |
EG: 3×/week, 6 upper-body exercises and 4 lower-body exercises (maximum 12 reps), 3–7 sets, total 40–50 sets, rest interval: 30 s–2 min; 60 min, supervised heavy resistance training concentrating on the strengthening of major muscle groups CG: rest |
10 weeks | HbA1c ↓ significantly in EG Total cholesterol ↓ significantly in EG Blood glucose ↓ significantly in EG Triglyceride, LDL-C ↓ in EG HDL-C in EG Weight in both Strength, endurance ↑ significantly in EG |
2 |
| Fuchsjager-Maryle et al. 2002 [32] | EG: 18 (11 F; 7 M) CG: 8 (3 F; 5 M) |
EG: 42 ± 10; CG: 33 ± 11 |
EG: 20 ± 10; CG: 20 ± 10 |
EG: 2×/week at weeks 1–2; 3×/week at weeks 3–16; stationary cycling with increasing resistance till 60–70% HR; 3–5 min WU + 40 min + 5 min CD, supervised exercise CG: no training intervention |
16 weeks | Weight in EG BMI in EG VO2max ↑ significantly in EG HbA1c, LDL-C, HDL-C, triglycerides in EG Total cholesterol tended ↓ in EG Daily insulin dosage ↓ significantly in EG Isometric muscle strength of both legs ↑ significantly in EG |
3 |
| Gusso et al. 2017 [25] | EG: 38 CG: 15 |
EG: 15.6 ± 1.3; CG: 15.5 ± 0.9 |
EG: 5.4 ± 3.4; CG: 7.5 ± 4.0 |
EG: 4×/week; (3×aerobic sessions + 1×resistance)/week at weeks 1–12, 4× circuit training/week at weeks 12–20; aerobic exercise: progressively to 85% HRmax at weeks 1–4; 85% HRmax at weeks 5–20; 40 min/session; resistance training: weight training and core exercise; 60 min exercise sessions per week (including WU and CD), supervised exercise CG: no training intervention |
20 weeks | Body weight ↑ significantly in both groups Body fat percentage ↓ in EG, ↑ in CG Fat-free mass ↑ in EG HbA1c in both groups VO2peak ↑ in EG DBP (resting) ↓ significantly in EG Daily insulin dosage ↓ in EG |
7 |
| Heyman et al. 2007 [33] | EG: 9 (F) CG: 7 (F) |
EG: 15.9 ± 1.5; CG: 16.3 ± 1.2 |
EG: 6.3 ± 4.4; CG: 8.4 ± 4.5 |
EG: 2×/week; 80–90% of HRR (measured by monitors); one 2-h supervised session + one 1-h unsupervised session, combined aerobic and strength sessions in ratio of 2:1 CG: spent equal amount of time on activities that did not require physical effort |
24 weeks | Body weight ↑ significantly in both groups Fat mass in EG, tended ↑ in CG Fat-free mass ↑ significantly in EG, in CG Daily insulin dosage in both groups PWC170 (aerobic fitness) in watts ↑ significantly in EG Total cholesterol, LDL-C, HDL-C, triglycerides in both groups Quality of life (DQOL) ↑ in EG |
4 |
| Huttunen et al. 1989 [34] | EG: 16 CG: 16 |
EG: 11.9 (8.2–16.9) CG: 11.9 (8.2–16.9) |
EG: 4.7 (0.6–12.0); CG: 5.6 (2.0–13.1) |
EG: 1×/week, HR >150 bpm, 60 min, aerobic exercise (jogging, running, gymnastics and various kinds of active games) CG: continued with normal PA behavior |
13 weeks | VO2peak ↑ significantly in EG, in CG HbA1c ↑ significantly in EG |
5 |
| Laaksonen et al. 2000 [35] | EG: 20 CG: 22 |
EG: 32.5 ± 5.7; CG: 29.5 ± 6.3 |
EG: 13.8 ± 9.2; CG: 10.8 ± 5.8 |
EG: 3×/week, 50–60% VO2peak, 20–30 min, at week 1, gradually increased to 4–5×/week, 60–80% VO2peak, 30–60 min at weeks 2–16, aerobic training CG: continued with normal PA behavior |
12–16 weeks | VO2peak ↑ significantly in EG; HbA1c, daily insulin dosage, BMI, body fat percentage in both groups Total cholesterol, LDL-C ↓ in EG; HDL-C ↑ in CG; Triglycerides changes significantly greater in EG than CG |
4 |
| Landt et al. 1985 [36] | EG: 9 (6 F; 3 M) CG: 6 (2 F; 4 M) |
EG: 16.1 ± 0.8; CG: 15.9 ± 0.3 |
EG: 6.7 ± 1.1; CG: 7.7 ± 1.5 |
EG: 3×/week, HR ≥160 bpm, 10 min WU + 25 min aerobic movement + 10 min CD, supervised exercise CG: continued with normal PA behavior |
12 weeks | Daily insulin dosage in both VO2max ↑ in EG Lean body mass ↑ in EG Insulin sensitivity ↑ in EG HbA1c in both groups |
4 |
| Maggio et al. 2011 [37] | EG: 15 (7 F; 8 M) CG: 12 (7 F: 5M) |
EG: 10.5 ± 2.0 CG: 10.5 ± 2.9 |
EG: 3.1 ± 2.7 CG: 3.4 ± 1.7 |
EG: 2×/week; HR ≥140 bpm, 10 min WU + 10 min drop jump (height of platform from 20 cm for the first 3 months to 40 cm in last 6 months) + 60 min weight-bearing activities + 10 min CD; weight-bearing: ball games, jumping, rope skipping, and gymnastics supervised exercise CG: relatively inactive |
36 weeks | BMI in both groups Boy weight in both groups |
8 |
| Newton et al. 2009 [38] | EG: 38 (16 F; 22 M) CG: 40 (20 F; 20 M) |
EG: 11–18 years CG: 11–18 years |
EG: wore open pedometer daily with a goal of 10,000 steps/day and received weekly text messages (reminding them to wear pedometer and be active) CG: received usual care for 12 weeks |
12 weeks | HbA1c in both groups SBP in both groups DBP in both groups BMI Z score in both groups Quality of life (SQOL) in both groups |
7 | |
| Perry et al. 1997 a 666crossover [39] | EG: 31 CG: 31 |
EG: 41.5 ± 11; CG: 41.5 ± 11 |
EG: 14.1 ± 11.9; CG: 14.1 ± 11.9 |
EG: intensive lifestyle education with ≥3×/week, intensity and duration were based on individual fitness level and goals (walking, cycling, running, weight training); non-supervised and individualized aerobic PA CG: received standard care |
24 weeks | Weight ↓ significantly in EG HbA1 ↓ not significantly in EG Triglycerides, total cholesterol, LDL-C in EG HDL-C ↑ in EG VO2max ↑ in EG BP in EG |
5 |
| Perry et al. 1997 b [39] crossover |
EG: 30 CG: 30 |
EG: 42.8 ± 12.6; CG: 42.8 ± 12.6 |
EG: 16.8 ± 13; CG: 16.8 ± 13 |
EG: intensive lifestyle education with ≥3×/week, intensity and duration were based on individual fitness level and goals (walking, cycling, running, weight training); non-supervised and individualized aerobic PA CG: received standard care |
24 weeks | HbA1 ↓ not significantly in EG BP in EG Total, LDL-C ↓ significantly in EG Total, HDL-C in EG |
5 |
| Roberts et al. 2002 [40] | EG: 12 CG: 12 |
14 ± 1.2 | 5.0 ± 3.1 | EG: 3×/week, 45 min/session, HR ≥ 160 bpm, aerobic and anaerobic component in a ratio of 7:3; activities: running, light training circuits, games and aerobics; supervised exercise CG: unsupervised training |
12 weeks | Aerobic power score ↑ significantly in EG, in CG HbA1 in both groups BMI in both groups Body mass in both groups |
3 |
| Rowland et al. 1985 crossover [41] | EG: 14 CG: 14 |
(9–14) | 4.2 (0.5–9.5) | EG: 3×/week, 10 min stretching + 20 min alternating 5-min walking/running increased to 30 min running 60% of HRR (160 bpm) + 5 min CD; recreational swim for 15 min twice weekly CG: rest |
12 weeks | VO2max ↑ in EG HbA1c in both groups |
6 |
| Salem et al. 2010 a [2] | EG: 75 CG: 48 |
EG: 14.7 ± 2.2; CG: 15 ± 2.35 |
EG: 3.6 ± 1.8; CG: 4.9 ± 1.9 |
EG: 1×/week, 65 min; supervised exercise (1) Aerobic exercise (cycling/treadmill) at 65–85% HRmax (2) Anaerobic exercise (treadmill interval running at 85–95% HRmax for 1–2 min) (3) Leg extension and leg curl exercises (progressive resistive exercises, 10RM) (4) Different free strength and endurance exercises (10 min, 10 reps/set, number of sets increasing gradually) (5) Flexibility exercises (5 min stretching) (6) Neuromuscular exercises (5 min coordination exercises, 10 reps balance exercise regime on firm surface for 10 min, 10 reps which increased from 1 set to 3 sets after 6 sessions. CG: continued with normal PA behavior |
24 weeks | HbA1c ↓ significantly in EG BMI (SDS) ↓ significantly in EG, in CG Daily insulin dosage ↓ significantly in EG HDL-C ↑ significantly in EG, in CG Triglycerides, total cholesterol, LDL-C ↓ in EG |
4 |
| Salem et al. 2010 b [2] | EG: 73 CG: 48 |
EG: 14.5 ± 2.4; CG: 15 ± 2.35 |
EG: 5.5 ± 2; CG: 4.9 ± 1.9 |
EG: 3×/week, 65 min; supervised exercise (1) Aerobic exercise (cycling/treadmill) at 65–85% HRmax (2) Anaerobic exercise (treadmill interval running at 85–95% HRmax for 1–2 min) (3) Leg extension and leg curl exercises (progressive resistive exercises, 10RM) (4) Different free strength and endurance exercises (10 min, 10 reps/set, number of sets increasing gradually) (5) Flexibility exercises (5 min stretching) (6) Neuromuscular exercises (5 min coordination exercises, 10 reps balance exercise regime on firm surface for 10 min, 10 reps which increased from 1 set to 3 sets after 6 sessions. CG: continued with normal PA behavior |
24 weeks | HbA1c ↓ significantly in EG Daily insulin dosage ↓ in EG BMI (SDS) ↓ significantly in EG, in CG DBP percentile ↓ in EG Triglycerides, total cholesterol, LDL-C HDL-C ↑ significantly in EG, in CG |
4 |
| Stratton et al. 1987 [42] | EG: 8 (4 F; 4 M) CG: 8 |
EG: 15.1 ± 1.2 CG: 15.5 ± 0.9 |
EG: 3.7 ± 2.1; CG: 5.5 ± 3.3 |
EG: 3×/week, 30–45 min of supervised highly aerobic activities (treadmill jogging, cycle ergometer) on 2 of the 3 days; on 1 of the 3 days, activities: basketball, swimming, or resistance exercise machines (mostly aerobic); diet advice once a week, supervised exercise CG: were encouraged to exercise and given an outline exercise program |
8 weeks | Daily insulin dosage ↓ in EG Bruce treadmill time, submaximal exercise heart rates ↑ in EG HbA1c, total cholesterol, triglycerides, HDL-C in both groups |
6 |
| Tunar et al. 2012 [43] | EG: 17 (11 F; 6 M) CG: 14 (5 F; 9 M) |
EG: 14.2 ± 2.2; CG: 14.3 ± 1.8 |
EG: 5.3 ± 4.1; CG: 6 ± 4.2 |
EG: 3×/week, 45 min, mat-based Pilates CG: continued with normal PA behavior |
12 weeks | BMI SDS in both groups HbA1c, daily insulin dosage in both groups HDL-C ↑ in CG LDL-C, total cholesterol, triglycerides in both groups Peak power, mean power, flexibility, vertical jump ↑ significantly in EG |
5 |
| Wallberg-Henriksson et al. 1986 [44] | EG: 6 (F) CG: 7 (F) |
EG: 36 ± 2 (SEM); CG: 35 ± 2 (SEM); |
EG: 14 ± 4 (SEM); CG: 13 ± 2 (SEM) |
EG: 7×/week, 5 min low intensity WU + 15 min high intensity cycling at 60–70% VO2max for first month, 70–80% VO2max for the second and third month, 75–90% VO2max for last 2 months) CG: continued with normal PA behavior |
20 weeks | VO2max ↑ significantly in EG HbA1c in both groups Total cholesterol ↓ in both groups LDL-C, total triglycerides, blood glucose, HDL-C in both groups |
4 |
| Wong et al. 2011 [45] | Home-based EG: 12 Self-directed EG: 5CG:11 |
Home-based EG: 11.62 ± 2.12; Self-directed EG: 13.44 ± 2.23 CG: 12.77 ± 1.79 |
Home-based EG: 4.42 ± 2.58; Self-directed EG: 3.42 ± 3.48; CG: 3.82 ± 2.87 |
Home-based EG: 3×/week, 10–30% HRR during WU and CD; 40–60% HRR during aerobic exercises; 10–20 min at week 1 to 20–30 min at weeks 3–12, delivered via VCR and/or phone; aid compliance and a handbook to provide guidance and exercise log, Self-directed EG: self-directed exercise CG: continued with normal PA behavior |
12 weeks | HbA1c in home-based EG, self-directed EG, CG at each study point; Self-directed EG had higher HbA1c than home-based EG; CG had higher HbA1c than self-directed EG at 9-month follow-up; VO2peak in all groups |
6 |
| Yki-Jarvinen et al. 1984 [46] | EG: 7 (1 F; 6 M) CG: 6 (2 F; 4 M) |
EG: 26 ± 1; CG: 24 ± 1 |
EG: 7 ± 1; CG: 9 ± 1 |
EG: 4×/week, 150–160 bpm, 60 min (4 × 15 min with 5-min rest intervals) CG: sedentary activity |
6 weeks | VO2max ↑ significantly in EG HbA1c in EG Daily insulin dosage ↓ significantly in EG, in CG Triglycerides, total cholesterol, HDL-C, LDL-C
|
1 |
SD = standard deviation; SEM = standard error of the mean; EG = exercise group; CG = control group; F = female; M = male; PA = physical activity; min = minutes; s = seconds; WU = warm up; CD = cool down; HRmax = maximum heart rate; HR = heart rate; HRR = heart rate reserve; bpm = beats per minute; RM = repetition maximum; reps = repetitions; BMI = body mass index; SDS = standard deviation score; HbA1c = glycated hemoglobin; Fasting blood glucose levels = FBG; SBP = systolic blood pressure; DBP = diastolic blood pressure; VO2max = maximal oxygen uptake; VO2peak = peak oxygen uptake; PWC 170 = peak oxygen uptake and physical work capacity at a heart rate of 170 beats/min; HDL-C = high-density lipoprotein cholesterol; LDL-C = low density lipoprotein cholesterol; DQOL = diabetes quality-of-life; SF-36 = Short Form (36) Health Survey; DQOL = Diabetes Quality-of-life; SQOL= Subjective Quality of Life; PEDro = Physiotherapy Evidence Database; ↑ = increase; ↓ = decrease; = no changes; a, b data in the study included more than one condition.