07 Jul Diabetes: Combining Resistance with Aerobic Exercise May Be More Effective For Glucose Control
Medical Research: What are the main findings of the study?
Lukas Schwingshackl: The results of the present meta-analyses showed that, in patients with established diabetes, aerobic training might be more effective in reducing glycosylated haemoglobin and fasting glucose when compared with resistance training. Combined aerobic and resistance training was more powerful in reducing glycosylated haemoglobin compared with aerobic training, and more effective in reducing glycosylated haemoglobin, fasting glucose and tricylglycerols when compared with resistance training. However, these results could not be confirmed when only low risk of bias studies were included.
Medical Research: What should clinicians and patients take away from your report?
Lukas Schwingshackl: Combined aerobic and resistance training can be recommended as part of a lifestyle programme in the management of type 2 diabetes wherever possible. However, the interpretation of these findings with respect to their clinical relevance is limited by the overall low to moderate quality of the studies included, the lack of information on clinically important outcomes.
With respect to the potential side effects, 8/14 trials in the present meta-analysis reported adverse events such as hypoglycaemia, back pain, shoulder pain, musculoskeletal injury, tendonitis and other musculoskeletal discomforts following exercise, with no significant differences between the intervention groups. However, it remains possible that the number of adverse events will increase with the duration and intensity of exercise. There is evidence that supervised exercise is more effective than unsupervised training, but in practice it seems unlikely that most patients would have access to supervised exercise regimens of this intensity. It is possible that either aerobic training, resistance training or combined training may be easier to perform effectively without supervision, thus affecting the external validity of these results since only studies with supervised training were included.
Medical Research: What recommendations do you have for future research as a result of this study?
Lukas Schwingshackl: Further high quality with long-term exercise interventions including hard clinical endpoints (i.e. cardiovascular disease, mortality) are needed to develop definitive recommendations.
Lukas Schwingshackl, Benjamin Missbach, Sofia Dias, Jürgen König, Georg Hoffmann. Impact of different training modalities on glycaemic control and blood lipids in patients with type 2 diabetes: a systematic review and network meta-analysis. Diabetologia, 2014; DOI: 10.1007/s00125-014-3303-z