|Title of the paper:||Resistance training as potential therapeutic intervention in type 2 diabetes mellitus: a meta-analysis of randomized control trials|
|Authors:||Pedro Acosta-Manzano, Francisco M. Acosta, Marķa Rodriguez-Ayllon|
|Institution:||UNIVERSITY OF GRANADA|
|Department:||Department of Physical Education and Sports, Faculty of Sports Science. University of Granada, Spain; Sport and Health Research Centre, University of Granada, Spain.|
Type 2 diabetes mellitus (T2DM) represents one indirect cause of death worldwide1. Considering the disorders related to T2DM, and the foretold increase of its prevalence1, this global threaten and socioeconomic burden needs to be addressed through the implementation of effective-tailored strategies. In this regard, resistance training (RT) has been highlighted as a first-line intervention for the management of T2DM. Therefore, the main aims were to assess the effects of RT on glycaemic control, physical fitness, body composition, lipid profile, blood pressure, C-reactive protein, and quality of life in patients with T2DM; and to update the information regarding the factors that could explain between-study heterogeneity on health outcomes.
An electronic database search was performed on PubMed and Web of Science from January 1998 to November 2017. Randomized control trials (RCTs) analysing the effects of RT (=4 weeks, without co-interventions) on clinical outcomes of interest in adults with T2DM, were included. In the fixed/random effect models, RT was compared vs. control/aerobic training (AT) group (within-group changes from RT minus the comparison group).
Forty RCTs were meta-analysed. The raw mean difference in the within-group change in glycated haemoglobin (HbA1c) was -0.42% (p=0.001) between the RT and control group, and 0.07% (p=0.505) between the RT and AT group. RT improved significantly insulin levels and sensitivity, cardiorespiratory fitness, muscle strength, weight, body mass index, waist circumference, fat and lean body mass, triglycerides, high density lipoprotein-cholesterol (HDL-C), systolic blood pressure (SBP), and C-reactive protein compared to the control group (all p<0.02). Compared to the AT group, RT showed similar effects on these outcomes; excepting muscle strength (RT was more effective), and cardiorespiratory fitness and body mass index (AT improved them more). The meta-regressions suggested that some methodological aspects, and characteristics of the RT programs and patients, might influence the change in magnitude of specific outcomes: statistical analyses (total cholesterol), general methodological quality of studies (HbA1c; diastolic blood pressure), attrition and reporting bias (HbA1c), random sequence (SBP), age of the participants (HDL-C; SBP), HbA1c baseline levels (muscle strength; SBP), duration of the interventions (HbA1c; fasting glucose), and weekly volume (SBP).
RT is a life-enhancing therapeutic intervention with beneficial effects on glycaemic control, physical fitness, body composition, lipid profile, blood pressure, and C-reactive protein in adults with T2DM. Specific characteristics of the RT and patients should be considered to promote more tailored RT programs in this population.
Zheng Y et al., Nature Reviews Endricronology, 88-98 (2018)