Effects of exercise training parameters on cardiorespiratory fitness of individuals with type 2 diabetes mellitus: a systematic review and meta-analysis

Gabriela do Nascimento Cândido; Ana Paula Delgado Bomtempo Batalha; Gabriela Suéllen da Silva Chaves; Daniele Sirineu Pereira; Raquel Rodrigues Britto

doi:10.1007/s40200-023-01205-5

Effects of exercise training parameters on cardiorespiratory fitness of individuals with type 2 diabetes mellitus: a systematic review and meta-analysis

J Diabetes Metab Disord. 2023 Mar 31;22(1):97-118. doi: 10.1007/s40200-023-01205-5. eCollection 2023 Jun.

Authors

Gabriela do Nascimento Cândido¹, Ana Paula Delgado Bomtempo Batalha², Gabriela Suéllen da Silva Chaves³, Daniele Sirineu Pereira⁴, Raquel Rodrigues Britto⁴

Affiliations

¹ Graduate Program in Rehabilitation Sciences, Federal University of Minas Gerais, Avenida Presidente Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG CEP: 31270-901 Brazil.
² Graduate Program in Rehabilitation Sciences and Physical-Functional Performance, Faculty of Physical Therapy, Federal University of Juiz de Fora, Av. Eugênio Do Nascimento S/N, Juiz de Fora, MG CEP: 36038-330 Brazil.
³ Myant Inc, Toronto, Canada.
⁴ Department of Physical Therapy, Federal University of Minas Gerais, Avenida Presidente Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG CEP: 31270-901 Brazil.

Abstract

Purpose: To assess the effects of exercise training parameters on cardiorespiratory fitness of individuals with type 2 diabetes mellitus (T2DM).

Methods: This systematic review was registered on PROSPERO (CRD42020210470). Searches were performed on PubMed, PEDro EMBASE, MEDLINE (Ovid), LILACS, PsycINFO, SCIELO, CINAHL, and Cochrane Library. The primary outcome was cardiorespiratory fitness, defined as maximal oxygen uptake (VO_2max) during a maximal or submaximal exercise test. Two independent reviewers extracted data and assessed the risk of bias. Data were pooled using a random effects model and expressed as mean difference (MD) and 95% confidence interval (95%CI). Heterogeneity (I²) was assessed using Cochran's Q test. The risk of bias and quality of evidence was assessed using the Cochrane risk of bias tool and GRADE.

Results: Twenty-two studies comparing exercise and control groups were included. The risk of bias indicated some concerns in most studies, and the quality of evidence was rated very low. Interventions with moderate (MD = 1.91, 95%CI = .58 to 3.34) and progressive exercise intensity (MD = 2.70, 95%CI = 2.43 to 2.96) and volume (MD = 1.72, 95%CI = .59 to 2.85) showed greater improvements in VO_2max.

Conclusions: Protocols that progressively increased exercise training parameters improved the cardiorespiratory fitness response. Progressive exercise might be more suitable for individuals with T2DM. Our conclusion may be limited due to the very low quality of evidence.

Supplementary information: The online version contains supplementary material available at 10.1007/s40200-023-01205-5.

Keywords: Cardiorespiratory fitness; Exercise; Systematic review; Type 2 diabetes mellitus.

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Publication types

Review