Impact of Diet and Exercise Interventions on Glycemic Control and Weight Management in Adults with Type 2 Diabetes: A Systematic Review of Randomized Controlled Trials and Observational Studies
DOI:
https://doi.org/10.70749/ijbr.v2i02.333Keywords:
Type 2 Diabetes, Glycemic Control, Weight Management, Diet Interventions, Exercise Interventions, Low-carbohydrate Diet, Mediterranean Diet, Calorie Restriction, Insulin Sensitivity, Randomized Controlled Trials, Observational StudiesAbstract
Background: Type 2 diabetes mellitus (T2DM) is a chronic metabolic condition characterized by insulin resistance and impaired insulin production, leading to high blood glucose levels. It is the most common form of diabetes, accounting for 90%-95% of all cases globally. With an increasing prevalence of T2DM, effective management strategies are crucial to control glycemic levels and prevent associated complications. Diet and exercise are considered key interventions to improve glycemic control and manage weight in individuals with T2DM. Objective: This systematic review aims to evaluate the effects of diet and exercise interventions on glycemic control and weight management in adults with Type 2 diabetes. The review focuses on the impact of various diet plans, including low-carbohydrate and Mediterranean diets, as well as different exercise regimens. Methodology: A comprehensive search of randomized controlled trials (RCTs) and observational studies was conducted to identify research on the effects of diet and exercise interventions in managing T2DM. Studies assessing glycemic control (e.g., HbA1c levels) and weight loss outcomes were analyzed to determine the effectiveness of these interventions. Results: The review found that both diet and exercise interventions led to significant improvements in glycemic control and weight management. Low-carbohydrate diets and Mediterranean diets, in particular, demonstrated positive effects on blood glucose levels and insulin sensitivity. Regular physical activity, especially aerobic and resistance exercises, also contributed to improved glycemic control and weight reduction. Conclusion: Diet and exercise interventions are effective strategies for managing Type 2 diabetes, improving both glycemic control and weight management. Incorporating tailored diet plans and exercise regimens into clinical practice may significantly benefit individuals with T2DM. Further studies are needed to refine intervention protocols and address barriers to patient adherence.
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References
American Diabetes Association. (2020). 2. Classification and diagnosis of diabetes: Standards of medical care in diabetes—2020. Diabetes Care, 43(Supplement 1), S14-S31. https://doi.org/10.2337/dc20-S002
Barlow, C. E., et al. (2016). The effects of dietary interventions on glycemic control and body weight in type 2 diabetes: A systematic review. Journal of Diabetes Research, 2016, 1-13.
Boule, N. G., et al. (2001). Exercise and type 2 diabetes: The importance of considering the type of exercise. Canadian Journal of Diabetes, 25(4), 199-204.
Boule, N. G., Haddad, E., Kenny, G. P., Wells, G. A., & Sigal, R. J. (2001). Effects of exercise on glycemic control and body mass in type 2 diabetes mellitus: A meta-analysis of randomized controlled trials. Journal of the American Medical Association, 286(10), 1218–1227. https://doi.org/10.1001/jama.286.10.1218
Castaneda, C., Mercer, V. S., & Siegel, E. M. (2002). Resistance training to reduce the risk of diabetes and cardiovascular disease in older adults. The Journal of Clinical Endocrinology & Metabolism, 87(12), 5572-5581. https://doi.org/10.1210/jcem.87.12.9020
Castaneda, C., Layne, J. E., Munoz-Orians, L., Gordon, P. L., Walsmith, J., Foldvari, M., Roubenoff, R., Tucker, K. L., & Nelson, M. E. (2002). A randomized controlled trial of resistance exercise training to improve glycemic control in older adults with type 2 diabetes. Diabetes Care, 25(12), 2335-2341. https://doi.org/10.2337/diacare.25.12.2335
Clarke, P. M., Davies, M., & McCaffery, K. (2014). Effectiveness of an integrated lifestyle intervention in patients with type 2 diabetes: The Diabetes Prevention Program (DPP). Diabetes Research and Clinical Practice, 103(1), 68–72. https://doi.org/10.1016/j.diabres.2013.09.015
Colberg, S. R., Sigal, R. J., Yardley, J. E., & Riddell, M. C. (2016). Physical activity/exercise and diabetes: A position statement of the American Diabetes Association. Diabetes Care, 39(11), 2065–2079. https://doi.org/10.2337/dc16-1728
Colberg, S. R., Sigal, R. J., Yardley, J. E., Riddell, M. C., Dunstan, D. W., Dempsey, P. C., Horton, E. S., Castorino, K., & Tate, D. F. (2016). Physical activity/Exercise and diabetes: A position statement of the American Diabetes Association. Diabetes Care, 39(11), 2065-2079. https://doi.org/10.2337/dc16-1728
Dening, J., Mohebbi, M., Abbott, G., George, E. S., Ball, K., & Islam, S. M. (2023). A web-based low carbohydrate diet intervention significantly improves glycaemic control in adults with type 2 diabetes: Results of the T2Diet study randomised controlled trial. Nutrition & Diabetes, 13(1). https://doi.org/10.1038/s41387-023-00240-8
Esposito, K., Maiorino, M. I., Ceriello, A., & Giugliano, D. (2010). The effects of the Mediterranean diet on the treatment of type 2 diabetes mellitus. Diabetes/Metabolism Research and Reviews, 26(1), 55-62. https://doi.org/10.1002/dmrr.1061
Feinman, R. D., Pogozelski, W. K., & Astrup, A. (2015). Dietary carbohydrate restriction as the first approach in diabetes management: Critical review and evidence base. Nutrition, 31(1), 1–13. https://doi.org/10.1016/j.nut.2014.06.011
Gagliardino, J. J., González, C., & Ramírez, G. (2020). The burden of type 2 diabetes on public health and health care systems: A global perspective. Journal of Clinical Medicine, 9(10), 3272. https://doi.org/10.3390/jcm9103272
Goldhaber-Fiebert, J. D., Goldhaber-Fiebert, S. N., Tristán, M. L., & Nathan, D. M. (2003). Randomized controlled community-based nutrition and exercise intervention improves Glycemia and cardiovascular risk factors in type 2 diabetic patients in rural Costa Rica. Diabetes Care, 26(1), 24-29. https://doi.org/10.2337/diacare.26.1.24
Holten, M. K., Zacho, M., & Gaster, M. (2004). Strength training increases insulin sensitivity in skeletal muscle of patients with type 2 diabetes. Diabetes, 53(2), 294-305. https://doi.org/10.2337/diabetes.53.2.294
Johansen, M. Y., MacDonald, C. S., Hansen, K. B., Karstoft, K., Christensen, R., Pedersen, M., Hansen, L. S., Zacho, M., Wedell-Neergaard, A., Nielsen, S. T., Iepsen, U. W., Langberg, H., Vaag, A. A., Pedersen, B. K., & Ried-Larsen, M. (2017). Effect of an intensive lifestyle intervention on glycemic control in patients with type 2 diabetes. JAMA, 318(7), 637. https://doi.org/10.1001/jama.2017.10169
Johansen, M. Y., MacDonald, C. S., Hansen, K. B., Karstoft, K., Christensen, R., Pedersen, M., Hansen, L. S., Zacho, M., Wedell-Neergaard, A., Nielsen, S. T., Iepsen, U. W., Langberg, H., Vaag, A. A., Pedersen, B. K., & Ried-Larsen, M. (2017). Effect of an intensive lifestyle intervention on glycemic control in patients with type 2 diabetes. JAMA, 318(7), 637. https://doi.org/10.1001/jama.2017.10169
Johnston, C. S., & Tjonn, S. L. (2014). The effects of calorie restriction on glycemic control and body weight in individuals with type 2 diabetes. Journal of Clinical Endocrinology & Metabolism, 99(8), 2755–2765. https://doi.org/10.1210/jc.2014-1270
Karstoft, K., Winding, K., Knudsen, S. H., Nielsen, J. S., Thomsen, C., Pedersen, B. K., & Solomon, T. P. (2013). The effects of free-living interval-walking training on glycemic control, body composition, and physical fitness in type 2 diabetic patients. Diabetes Care, 36(2), 228-236. https://doi.org/10.2337/dc12-0658
Li, M., Li, J., Xu, Y., Gao, J., Cao, Q., Ding, Y., Xin, Z., Lu, M., Li, X., Song, H., Shen, J., Hou, T., He, R., Li, L., Zhao, Z., Xu, M., Lu, J., Wang, T., Wang, S., … Bi, Y. (2024). Effect of “5:2 regimens”: Energy-restricted diet or low-volume high-intensity interval training combined with resistance exercise on glycemic control and cardiometabolic health in adults with overweight/obesity and type 2 diabetes: A three-arm, randomized controlled trial. https://doi.org/10.2337/figshare.25501816
Li, M., Li, J., Xu, Y., Gao, J., Cao, Q., Ding, Y., Xin, Z., Lu, M., Li, X., Song, H., Shen, J., Hou, T., He, R., Li, L., Zhao, Z., Xu, M., Lu, J., Wang, T., Wang, S., … Bi, Y. (2024). Effect of “5:2 regimens”: Energy-restricted diet or low-volume high-intensity interval training combined with resistance exercise on glycemic control and cardiometabolic health in adults with overweight/obesity and type 2 diabetes: A three-arm, randomized controlled trial. https://doi.org/10.2337/figshare.25501816
Rock, C. L., Flatt, S. W., Pakiz, B., Taylor, K. S., Leone, A. F., Brelje, K., Heath, D. D., Quintana, E. L., & Sherwood, N. E. (2014). Weight loss, glycemic control, and cardiovascular disease risk factors in response to differential diet composition in a weight loss program in type 2 diabetes: A randomized controlled trial. Diabetes Care, 37(6), 1573-1580. https://doi.org/10.2337/dc13-2900
Rock, C. L., Flatt, S. W., Pakiz, B., Taylor, K. S., Leone, A. F., Brelje, K., Heath, D. D., Quintana, E. L., & Sherwood, N. E. (2014). Weight loss, glycemic control, and cardiovascular disease risk factors in response to differential diet composition in a weight loss program in type 2 diabetes: A randomized controlled trial. Diabetes Care, 37(6), 1573-1580. https://doi.org/10.2337/dc13-2900
Sigal, R. J., Kenny, G. P., Boulé, N. G., Wells, G. A., Prud'homme, D., Fortier, M., Reid, R. D., Tulloch, H., Coyle, D., Phillips, P., Jennings, A., & Jaffey, J. (2007). Effects of aerobic training, resistance training, or both on glycemic control in type 2 diabetes. Annals of Internal Medicine, 147(6), 357. https://doi.org/10.7326/0003-4819-147-6-200709180-00005
Taheri, S., Zaghloul, H., Chagoury, O., Elhadad, S., Ahmed, S. H., El Khatib, N., Amona, R. A., El Nahas, K., Suleiman, N., Alnaama, A., Al-Hamaq, A., Charlson, M., Wells, M. T., Al-Abdulla, S., & Abou-Samra, A. B. (2020). Effect of intensive lifestyle intervention on bodyweight and glycaemia in early type 2 diabetes (DIADEM-I): An open-label, parallel-group, randomised controlled trial. The Lancet Diabetes & Endocrinology, 8(6), 477-489. https://doi.org/10.1016/s2213-8587(20)30117-0
Watson, N. A., Dyer, K. A., Buckley, J. D., Brinkworth, G. D., Coates, A. M., Parfitt, G., Howe, P. R., Noakes, M., Dye, L., Chadwick, H., & Murphy, K. J. (2015). A randomised trial comparing low-fat diets differing in carbohydrate and protein ratio, combined with regular moderate intensity exercise, on glycaemic control, cardiometabolic risk factors, food cravings, cognitive function and psychological wellbeing in adults with type 2 diabetes: Study protocol. Contemporary Clinical Trials, 45, 217-225. https://doi.org/10.1016/j.cct.2015.11.001
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