title: Effects of exercise training on arterial function in type 2 diabetes mellitus: a systematic review and meta-analysis.
abstract: OBJECTIVE
  Controversy exists among trials assessing whether exercise can improve arterial function in type 2 diabetes mellitus (T2DM) subjects. Therefore the aim of this study was to systematically review and quantify the effects of exercise on arterial function in T2DM subjects.
  
  
  METHODS
  MEDLINE, Cochrane, Scopus and Web of Science were searched up until January 2013 for randomized controlled trials evaluating the effects of exercise interventions lasting 4 weeks or more on arterial function in T2DM subjects. Flow-mediated dilation (FMD) and nitrate-mediated dilation (NMD) of the brachial conduit artery were considered for assessment of arterial endothelial function and smooth muscle function, respectively.
  
  
  RESULTS
  Five randomized trials comparing exercise and control groups (overall n = 217) met the inclusion criteria. The mean exercise characteristics were as follows: 3.6 sessions per week, 67.5 min per session, intensity at 74.4 % of the maximum heart rate (HR(max)), for 14 weeks. The post-intervention mean difference in FMD favoured the exercise groups over the control groups (2.23 %; P < 0.0001). No significant post-intervention mean difference in NMD (1.22 %; P = 0.29) was found between the groups. Neither heterogeneity nor publication bias was detected among the trials.
  
  
  CONCLUSIONS
  Exercise training alone improved FMD, showing its capacity to restore arterial endothelial function in T2DM subjects. However, further research is needed to determine whether longer and/or more intense exercise interventions could enhance arterial smooth muscle function in this population.
authors.affiliation: Avignon University, LAPEC EA4278, 84000, Avignon, France, david.montero.barril@gmail.com.
authors.forename: David
authors.initials: D
authors.lastname: Montero
authors.forename: Guillaume
authors.initials: G
authors.lastname: Walther
authors.forename: Eric
authors.initials: E
authors.lastname: Benamo
authors.forename: Antonia
authors.initials: A
authors.lastname: Perez-Martin
authors.forename: Agnès
authors.initials: A
authors.lastname: Vinet
mesh_terms: D001158:Arteries / Q000503:physiopathology*; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D004727:Endothelium / Q000503:physiopathology; D015444:Exercise / Q000502:physiology*; D006801:Humans; D009131:Muscle, Smooth, Vascular / Q000187:drug effects / Q000503:physiopathology; D020030:Nitric Oxide Donors / Q000494:pharmacology; D014664:Vasodilation / Q000187:drug effects / Q000502:physiology
chemical_list: D020030:Nitric Oxide Donors
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