title: Clinical outcomes and glycaemic responses to different aerobic exercise training intensities in type II diabetes: a systematic review and meta-analysis.
abstract: To establish if aerobic exercise training is associated with beneficial effects on clinical outcomes and glycaemic profile in people with type II diabetes.
  
  
  
  A systematic search was conducted to identify studies through a search of MEDLINE (1985 to Sept 1, 2016, Cochrane Controlled Trials Registry (1966 to Sept 1, 2016), CINAHL, SPORTDiscus and Science Citation Index. The search strategy included a mix of MeSH and free text terms for related key concepts. Searches were limited to prospective randomized or controlled trials of aerobic exercise training in humans with type II diabetes, aged >18 years, lasting >2 weeks.
  
  
  
  Our analysis included 27 studies (38 intervention groups) totalling 1372 participants, 737 exercise and 635 from control groups. The studies contain data from 39,435 patient-hours of exercise training. Our analyses showed improvements with exercise in glycosylated haemoglobin (HbA1C%) MD: -0.71%, 95% CI -1.11, -0.31; p value = 0.0005. There were significant moderator effects; for every additional week of exercise HbA1C% reduces between 0.009 and 0.04%, p = 0.002. For those exercising at vigorous intensity peak oxygen consumption (peak VO2) increased a further 0.64 and 5.98 ml/kg/min compared to those doing low or moderate intensity activity. Homeostatic model assessment of insulin resistance (HOMA-IR) was also improved with exercise MD: -1.02, 95% CI -1.77, -0.28; p value = 0.007; as was fasting serum glucose MD: -12.53 mmol/l, 95% CI -18.94, -6.23; p value <0.0001; and serum MD: -10.39 IU, 95% CI -17.25, -3.53; p value = 0.003.
  
  
  
  Our analysis support existing guidelines that for those who can tolerate it, exercise at higher intensity may offer superior fitness benefits and longer program duration will optimize reductions in HbA1C%.
authors.affiliation: School of Science and Technology, University of New England, Armidale, NSW, 2351, Australia.
authors.forename: Aimee
authors.initials: A
authors.lastname: Grace
authors.affiliation: School of Medicine, Griffith University, Gold Coast, Australia.
authors.forename: Erick
authors.initials: E
authors.lastname: Chan
authors.affiliation: Division of Internal Medicine and Cardiac Rehabilitation, Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Giallauria
authors.affiliation: Department of Statistics, Macquarie University, North Ryde, Sydney, NSW, 2113, Australia.
authors.forename: Petra L
authors.initials: PL
authors.lastname: Graham
authors.affiliation: School of Science and Technology, University of New England, Armidale, NSW, 2351, Australia. nsmart2@une.edu.au.
authors.forename: Neil A
authors.initials: NA
authors.lastname: Smart
mesh_terms: D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D005082:Physical Exertion / Q000502:physiology*; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose
keywords: Cardio-respiratory fitness; Exercise intensity; Type II diabetes