Comparison of control fasting plasma glucose of exercise-only versus exercise-diet among a pre-diabetic population: a meta-analysis.
OBJECTIVE
Exercise is considered a protective factor in the prevention of type 2 diabetes, although its role as a sole treatment for pre-diabetes remains unknown. The present meta-analysis compared the effect of exercise-only with exercise-diet interventions on plasma glucose levels among a pre-diabetic population.


METHODS
A literature search was conducted using PubMed, EMBASE and Cochrane databases. The Cochrane Collaboration tool was used to assess the quality of each trial. Two reviewers independently performed quality assessment of all included articles. A random effects model was used to calculate the pooled effect.


RESULTS
A total of 4021 participants from 12 studies were included in this meta-analysis, 2045 of them were in the intervention group and 1976 were in the control group. Compared with the exercise-only interventions, the exercise-diet interventions showed a significant effect on decreasing fasting plasma glucose (FPG) levels, with a weighted mean difference (WMD) =-0.22 mmol/l, 95% confidence interval (CI): -0.25, -0.18 (Z=12.06, P<0.05). The subgroup effect of exercise-only interventions did not produce a statistically significant result (WMD=-0.09 mmol/l, 95% CI: -0.18, 0.00, Z=1.91, P>0.05). According to the intervention periods, the pooled effect in the ⩾2-year group was the highest, and its WMD (95% CI) was -0.24 mmol/l (-0.43,-0.05). The pooled effects were statistically significant among the elderly and those of American and European descent, with WMD (95% CI) being -0.19 mmol/l (95% CI: -0.22, -0.15), -0.17 mmol/l (-0.21,-0.12) and -0.22 mmol/l (-0.27, -0.17), respectively.


CONCLUSIONS
Evidence from published trials indicates that exercise-diet interventions showed a significant effect on decreasing FPG levels.
Department of Cardiovascular Medicine, Research Center for Translational Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
L
L
Zheng
Department of Preventive Medicine, Tongji University School of Medicine, Shanghai, China.
J
J
Wu
Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China.
G
G
Wang
Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA.
G
G
Persuitte
Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA.
Y
Y
Ma
Department of Preventive Medicine, Tongji University School of Medicine, Shanghai, China.
L
L
Zou
Department of Preventive Medicine, Tongji University School of Medicine, Shanghai, China.
L
L
Zhang
Department of Preventive Medicine, Tongji University School of Medicine, Shanghai, China.
M
M
Zhao
Department of Preventive Medicine, Medical School of Yangzhou University, Yangzhou, China.
J
J
Wang
Department of Cardiovascular Medicine, Research Center for Translational Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
Qin
Q
Lan
Department of Cardiovascular Medicine, Research Center for Translational Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
Z
Z
Liu
Department of Cardiovascular Medicine, Research Center for Translational Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
H
H
Fan
Department of Preventive Medicine, Tongji University School of Medicine, Shanghai, China.|Key Laboratory of Arrhythmias of Ministry of Education of China, Tongji University, Shanghai, China.|Heart, Lung and Blood Vessel Center, Tongji University School of Medicine, Shanghai, China.
J
J
Li
D001786:Blood Glucose / Q000378:metabolism*; D004032:Diet; D015444:Exercise; D006801:Humans; D011236:Prediabetic State / Q000097:blood* / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic
D001786:Blood Glucose