Optimal strategies for exercise intervention in older people diabetic patients: The impacts of intensity, form, and frequency on glycemic control: An exercise prescription for older people with diabetes

Arch Gerontol Geriatr. 2025 Jan:128:105621. doi: 10.1016/j.archger.2024.105621. Epub 2024 Sep 14.

Abstract

Objective: This study aims to investigate the optimal exercise intensity, type, and weekly duration for improving glycated haemoglobin (HbA1c) and fasting blood glucose (FBG) levels in older people individuals with diabetes.

Materials and methods: PubMed, EMBASE, Web of Science and other databases were searched to identify randomised controlled trials (RCTs) starting from January 2000 to February 2024 that reported improved effects on fasting glucose and glycated haemoglobin after different exercises in middle-aged and elderly diabetic patients. Meta-analyses Review Manager V.5.3 was used.

Results: Meta-analysis showed that moderate- and high-intensity exercise had a significant effect on HbA1c levels, with a mean difference (MD) of -0.34 (95 % CI: -0.44 ∼ -0.24, p < 0.01) for moderate-intensity exercise and -0.54 (95 % CI: -0.78 ∼ -0.3, p < 0.001) for high-intensity exercise.. Both moderate-intensity and high-intensity exercise demonstrated statistical significance in lowering fasting blood glucose levels (p < 0.001). Additionally, there was no significant difference between aerobic and resistance exercise forms (p= 0.72). Furthermore, for reducing HbA1c levels, engageing in weekly exercise for at least 2.5 hours showed a MD of-0.44(95 % CI:-0.63∼0.25;p<0.001).

Conclusions: In summary, in terms of exercise intensity, medium and high-intensity exercise can significantly reduce HbA1c and FBG levels in middle-aged and older people diabetic patients; in terms of exercise form, the effects of different exercise forms within medium and high-intensity on HbA1c and FBG are not statistically significant; and in terms of exercise time, in moderate-intensity aerobic exercise, older people exercising for more than 2.5 h per week are more beneficial.

Keywords: Diabetic older people; Exercise form;EXercise time;MEta-analysis; Exercise intensity.

Publication types

  • Meta-Analysis

MeSH terms

  • Aged
  • Aged, 80 and over
  • Blood Glucose* / metabolism
  • Diabetes Mellitus* / blood
  • Diabetes Mellitus* / therapy
  • Exercise / physiology
  • Exercise Therapy* / methods
  • Glycated Hemoglobin* / analysis
  • Glycemic Control* / methods
  • Humans
  • Middle Aged
  • Randomized Controlled Trials as Topic

Substances

  • Blood Glucose
  • Glycated Hemoglobin