The effects of exercise interventions on physical function tests and glycemic control in adults with type 2 diabetes: A systematic review

Introduction: Regular exercise improves glycemic control and helps to mitigate the decline in strength, mobility, and balance. The 6-min walk test (6MWT), timed up-and-go test (TUG) and the sit-to-stand test (STS) are reliable measures of physical function in adults with type 2 diabetes (T2D). Outcome measures allow physiotherapists to monitor changes in physical function with exercise prescription. Methods: PubMed, CINAHL, EMBASE and Scopus databases and reference lists of relevant reviews were searched for randomized controlled trials (RCTs) relating to exercise and T2D published until June 2020. Studies were included when: (a) participants were adults diagnosed with T2D, (b) exercise was a main intervention and compared to controls, and (c) at least one clinical physical function measure was used to detect changes in aerobic capacity, mobility or strength. Results: Eight of 10 RCTs reported either statistically significant between-group (p < 0.05) or within group (p < 0.05) differences in 6MWT scores. Nonsignificant between-group differences were found in two resistance training RCTs that utilized the TUG test. Three of five RCTs utilizing the STS test reported significant between groups differences (p < 0.05). Seven of 11 RCTs reported statistically significant between-group (p < 0.05) or within-group (p < 0.05) differences in glycated hemoglobin (HbA1c) levels. Conclusion: Physical function measures may be useful for monitoring aerobic capacity, lower extremity strength and mobility with exercise in patients with T2D. Improvements in 6MWT scores may depend on total volume of exercise (minutes/week * weeks of intervention). However, changes in HbA1c with exercise were variable and may depend on type of exercise. (C) 2021 Elsevier Ltd. All rights reserved.

Automated summary

Regular exercise improves glycemic control and helps mitigate decline in strength, mobility, and balance. Studies show reliable physical function measures such as 6MWT, TUG, and STS tracks changes in aerobic capacity, mobility, and strength in T2D patients post-exercise intervention.