Exercise Modes and their Association with Hypoglycaemia Episodes in Adults with Type 1 Diabetes Mellitus: A Systematic Review

Hasan, Saima and Shaw, Siân and Gelling, Leslie and Kerr, Catherine and Meads, Catherine (2018) Exercise Modes and their Association with Hypoglycaemia Episodes in Adults with Type 1 Diabetes Mellitus: A Systematic Review. BMJ Open Diabetes Research and Care, 6 (1). e000578. ISSN 2052-4897

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Official URL: http://dx.doi.org/10.1136/bmjdrc-2018-000578

Abstract

Objective: Type 1 diabetes mellitus rates are rising worldwide. Health benefits of physical exercise in this condition are many, but more than 60% do not participate, mainly from fear of hypoglycaemia. This systematic review explores effects of physical exercise modes on blood glucose levels in adults for hypoglycaemia prevention. Research Design and Methods: Predefined inclusion criteria were randomised or non-randomized crossover trials of healthy non-obese adults with type 1 diabetes mellitus. Exercise interventions used standardised protocols of intensity and timing. Outcomes included hypoglycaemia during or after exercise, and acute glycaemic control. Medline, CINAHL, AMED, SportDiscus, CENTRAL (1990–11/01/2018), Embase, (1988-09/04/2018) were searched using keywords and MeSH terms. Inclusions, data-extraction, and quality assessment using CASP checklists, were by one researcher and checked by a second. Meta-analysis used Revman (version 5.3) where four or more outcomes were reported. PROSPERO registration CRD42018068358. Results: From 5459 citations, we included 15 small crossover studies (3 non-randomised), 13 assessing aerobic (intermittent high-intensity exercise (IHE) versus continuous, or continuous versus rest) and 2 assessing resistance exercise versus rest. Study quality was good, and all outcome measures reported. Thirteen gave hypoglycaemia results, of which 5 had no episodes. Meta-analysis of hypoglycaemia during or after IHE compared to continuous exercise showed no significant differences (N=5,OR=0.68(95%CI0.16-2.86),I2=56%). For blood glucose there was little difference between groups at any time point. Conclusion: IHE may be safer than continuous exercise because of lesser decline in blood glucose, but more research needs to demonstrate if this would be reflected in hypoglycaemic episode rates.

Item Type: Journal Article
Keywords: diabetes, exercise, systematic review
Faculty: Faculty of Health, Social Care & Education (for research post September 2011)
Faculty of Medical Science
Depositing User: Professor Catherine Meads
Date Deposited: 04 Sep 2018 08:18
Last Modified: 30 Oct 2018 09:47
URI: http://arro.anglia.ac.uk/id/eprint/703538

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