Table 1.
Characteristics of the included studies
| Author year |
Country | Sample size (EX/CON) |
Combined exercise intervention | Control | Time points of data collection (week） |
Participant characteristics | Dropout rate (%) |
Outcomes | Adverse events | |||||||||||
| Exercise format | Supervision/facilitator | Exercise type | Intensity | Frequency (days/week) | Duration/session (min) |
Intervention time (weeks) |
Age (year） | BMI (kg/m2) |
T2D duration (years） |
|||||||||||
| AminiLari et al 201720 |
Iran | 30 (15/15) | Centre-based and group-based: each exercise session consisted of three phases—warm up, the main stage and a cool-down period | NR/NR | AE: cycle ergometer RE: leg extension, prone leg curl, abdominal crunch |
AE: 50%–55% of HRmax RE: 50%–55% 1 RM |
3 | 45–70 | 12 | NR | 0.12 | 45–60 | EX 29.0±2.6 CON 28.2±3.7 |
＞2 | 6.7 | HOMA-IR, serum insulin, BMI |
NR | |||
| Balducci et al 2010a14 | Italy | 606 (303/303) |
Centre-based and group-based: in metabolic fitness centre | Yes/exercise specialist | AE: treadmill, step, elliptical, cycle ergometer RE: four resistance exercises (eg, chest press, lateral pull down, leg press, trunk flexion for the abdominals) and three stretching position standard care: same as control group |
Low–high intensity | 2 | 75 | 48 | Standard care (counselling and diet management) Counselling: encouraging any type of commuting, occupational, home and leisure time physical activity, counselling was reinforced every 3 months; Diet management: caloric intake reduction, adherence to diet was verified by using food diaries and dietary prescriptions were adjusted at each intermediate visit. |
0.48 | EX 58.8±8.6 CON 58.8±8.5 |
EX 31.2±4.6 CON 31.9±4.6 |
6 (3–10) | 7.1 | HbA1c, HOMA-IR, serum insulin, SBP, DBP, TG, TC, HDL-C, LDL-C, BMI |
Shoulder pain, low back pain, aggravation of pre-existing osteoarthritis, musculoskeletal discomfort |
|||
| Balducci et al 2010b15 | Italy | 42 (22/20） |
Centre-based and group-based: NR | Yes/NR | AE: treadmill, cycloergometer RE: four resistance exercises (eg, chest press, lateral pull down, leg press, trunk flexion for the abdominals) and three stretching position Dietary prescriptions |
AE: 70%–80% VO2max RE: 80% 1 RM |
2 | 60 | 48 | Dietary prescriptions | 0, 12, 24, 36, 48 |
EX 60.6±9.3 CON 61.1±7.1 |
EX 30.5±0.9 CON 30.9±1.1 |
EX 8.5±5.7 CON 7.8±5.2 |
4.8 | HbA1c, HOMA-IR, SBP, DBP, TG, TC, HDL-C, LDL-C, BMI |
Musculo- skeletal injury | |||
| Banitalebi et al 201916 | Iran | 35 (17/18) |
Centre-based and group-based: in a hospital gym | Yes/exercise physiologists | AE: treadmill, cycle ergometer RE: bilateral leg press, lateral pull down, bench press, bilateral biceps curl and bilateral triceps push down |
AE: 60%–70% of HRmax RE: 10–15 RM |
3 | 50 | 10 | Usual medical care and diabetes recommendations for self-management | 0.10 | EX 54.1±5.4 CON 55.7±6.4 |
EX 28.7±4.3 CON 30.1±3.5 |
NR | 20.0 | HbA1c, HOMA-IR, serum insulin, BMI |
Muscle soreness | |||
| Bjorgaas et al 200521 | Norway | 29 (15/14) |
Centre-based and group-based: each exercise session consisted of three phases—warm up, the main stage, a cool-down and stretching period | Yes/physiotherapist | AE: light jogging, co-ordination exercises, knee bends and stretching RE: NR diet information: same as control group |
50%–85% HRmax |
2 | 90 | 12 | Diet information: a plenary session by a clinical nutritionist | 0.12 | EX 57.9±8.0 CON 56.9±7.8 |
EX 31.7±2.6 CON 31.8±3.0 |
EX 2.5 (0.1–17) CON 1.5 (0.1–15) |
10.3 | HbA1c, SBP, DBP |
Achilles tendinitis | |||
| Author year |
Country | Sample size (EX/CON) |
Exercise intervention | Control | Time points of data collection (week） |
Participant characteristics | Dropout rate (%) |
Outcomes | Adverse events | |||||||||||
| Exercise format | Supervision/facilitator | Exercise type | Intensity | Frequency (days/week) | Duration/session (min) |
Intervention time (weeks) |
Age (year) | BMI (kg/m2) |
T2D duration (years） |
|||||||||||
| Johansen et al 201722 | Zealand and Denmark | 98 (64/34) |
Group-based: the geographical location of the participants’ home address | Yes/physiotherapist and trainer | AE: power walking, cycling, jogging uphill or on stairs RE: anterior chain (thigh), posterior chain (thigh), chest, back and shoulders standard care: same as control group |
AE: 60%–90% HRmax RE: 10–12 RM |
5–6 | 30–60 | 48 | Standard care: medical counselling, education in type 2 diabetes and lifestyle advice by the study nurse at baseline and every 3 months for 12 months | 0.48 | EX 53.6±9.1 CON 56.6±8.1 |
EX 31.4±3.9 CON 32.5±4.5 |
EX 5 (3–8) CON 6 (3–9) |
5.1 | HbA1c, serum insulin, SBP, DBP, TG, TC, HDL-C, LDL-C, BMI |
Musculoskeletal pain or discomfort, mild hypotension, insomnia, peripheral oedema | |||
| Leehey et al 201617 | USA | 36 (18/18) |
12 weeks of centre-based exercise followed by 40 weeks of home-based exercise | Yes/trainer | AE: treadmill, elliptical trainer and cycle ergometer RE: using elastic bands, hand-held weights or weight machine Diet management: same as control group |
AE: interval RE: progressive |
Centre-based exercise: 3 Home-based exercise: 3or 6 |
Centre-based: 80–90 Home-based: 60 (3 times) 30 (6 times) |
52 | Diet management: nutritional counselling session at baseline with nine follow-up telephone calls | 0,12,52 | EX 65.4±8.7 CON 66.6±7.5 |
EX 36.2±4.8 CON 37.4±4.2 |
NR | 11.1 | HbA1c, SBP, TG, TC, HDL-C, LDL-C, BMI |
Cardiovascular disease, cervical myelopathy | |||
| Lucotti et al 201118 | Italy | 50 (30/20） |
Centre-based and group-based: in a hospital | Yes/physician | AE: row ergometer and bicycle ergometer RE: arm curls, military press, push-ups, upright rowing, back extension, squats knee extensions, heel raises and bent knee sit-ups Diet management: same as control group |
AE: 70% HRmax RE: 40%–50% of 1 RM |
5 | 45 | 3 | AE plus diet management: AE: 70% HR max 5 days/week,30 min/session; Diet management: hypocaloric diet regime administered under a daily supervision of a dietician |
0.3 | EX 61.5±11.5 CON 58.1±9.9 |
EX 39.9±7.3 CON 38.8±4.5 |
NR | 6.0 | HbA1c SBP, DBP, TG, TC, HDL-C, BMI |
NR | |||
| Otten et al 201719 | Sweden | 32 (16/16) |
Centre-based: in a Sports Medicine unit | Yes/trainer | AE: cross-trainer, cycle-ergometer, cycle-ergometer RE: leg presses, leg curls, hip raises, seated rows, dumbbell rows, shoulder raises, back extensions, burpees, sit-ups and wall ball shots Palaeolithic diet: same as control group |
AE: 40%–100% HRmax RE: NR |
3 | 60 | 12 | Palaeolithic diet, education about the diet and cooked food by a trained dietician at baseline and once a month | 0.12 | EX 61 (58–66) CON 60 (53–64) |
EX 31.7 (29.2–35.4) CON 31.4 (29.4–33.1) |
EX 5.5 (1–8) CON 3 (1–5) |
9.4 | HbA1c, serum insulin, SBP, DBP, TG, TC, HDL-C, LDL-C |
NR | |||
| Vinetti et al 201523 | Italy | 20 (10/10) |
Centre-based: in a hospital-based setting | Yes/trainer | AE: cycling on mechanically braked cycle ergometers RE: major muscle groups (upper limb, lower limb, chest, back and core), using callisthenics, repetitions with ankle weights and dumbbells Standard care: same as control group |
AE: interval RE: progressive |
NR | 55–85 | 48 | Standard care: dietary regimen prescribed by the diabetologist | 0.48 | EX 60.56 ±5.94 CON 57.5±9.46 |
EX 29.7±4.1 CON 29.2±3.11 |
≥2 | 0 | HbA1c, serum insulin, SBP, DBP, TG, TC, HDL-C, BMI |
NR | |||
AE, aerobic exercise; BMI, body mass index; CON, control group; DBP, diastolic blood pressure; EX, exercise group; HbA1c, haemoglobin A1c; HDL-C, high-density lipoprotein cholesterol; HOMA-IR, homeostasis model assessment of insulin resistance; HR, heart rate; LDL-C, low-density lipoprotein cholesterol; NR, not reported; RCT, randomised controlled trial; RE, resistance exercise; RM, repetition maximum; SBP, systolic blood pressure; TC, total cholesterol; T2D, type 2 diabetes; TG, triglycerides; VO2max, maximal oxygen consumption.