Exercise as a complementary medicine intervention in type 2 diabetes mellitus: A systematic review with narrative and qualitative synthesis of evidence.

BACKGROUND AND AIMS: Type 2 diabetes mellitus (T2DM) is a rapidly growing public health issue. This systematic review aimed to narrate and qualitatively synthesize evidence and recommendations of physical activity/exercise for patients with T2DM.

METHODS: The databases Medline through Pubmed, Cochrane, and Scopus were systematically searched from inception to February 08, 2020 using MeSH terms related to "diabetes mellitus" and "physical activity/exercise". Studies were included if they reported on the roles of physical activity/exercise in managing patients with T2DM or effects of physical activity/exercise on glycemic control. Documents identified through the search were analyzed and evidence and recommendations were synthesized qualitatively.

RESULTS: Data were extracted from 16 original articles and 11 systematic reviews with meta-analyses. A qualitative summary of evidence included general items (n = 6) and recommendations for physical activity/exercise (n = 12). Physical activity/exercise can reduce incidence of T2DM, hyperinsulinemia, fasting plasma/blood glucose, HbA1c, body fats, cholesterol, blood pressure, heart rate, cardiovascular risk, and dosage of antidiabetic medications. Physical activity/exercise can improve sensitivity to insulin, muscle strength, oxygen consumption, aerobic capacity, and mental health of patients with T2DM.

CONCLUSION: Despite the increasing interest in incorporating physical activity/exercise in the management of T2DM and improving healthcare delivery, there are still limited clear instructions and guidelines for both the patient and the healthcare provider.