Resistance Training for Glycemic Control, Muscular Strength, and Lean Body Mass in Old Type 2 Diabetic Patients: A Meta-Analysis

Abstract

IntroductionType 2 diabetes (T2D) in elderly patients is associated with accelerated loss of skeletal muscle mass and strength. However, there are few meta-analysis reviews which investigate the effects of resistance training (RT) on glycemic control and skeletal muscle in the patients.MethodsThree electronic databases were searched (from the earliest date available to November 2016). Studies were included according to the inclusion criteria: T2D patients at least 60 years old, fasting plasma glucose of at least 7.0, and at least 8 weeks of RT.ResultsFifteen cohorts of eight studies (360 patients, average age 66 years) met the inclusion criteria. RT groups lowered glycosylated hemoglobin (HbA1c) (mean ES = −0.37, 95% CI = −0.55 to −0.20, P < 0.01) but did not result in a significant effect on lean body mass (LBM) (mean ES = 0.08, 95% CI = −0.15 to 0.30, P = 0.50). Homogeneity was shown between studies regarding HbA1c and LBM (Q = 15.70, df = 9, P = 0.07 and Q = 0.12, df = 4, P = 0.998, respectively). High-intensity subgroups showed a slight tendency to improve (rather than duration, frequency, and weekly volume) and to decrease HbA1c levels more than low-intensity subgroups (P = 0.37). RT increased muscular strength (mean ES = 1.05, 95% CI = 0.26–1.84, P = 0.01). No training components explained the heterogeneity between studies with changes in muscle strength.ConclusionRT improves glycemic control and muscle strength in elderly patients with T2D. RT with high intensity can be a strategy to treat patients with T2D and sarcopenia associated with aging.

Beyond general resistance training. Hypertrophy versus muscular endurance training as therapeutic interventions in adults with type 2 diabetes mellitus: A systematic review and meta‐analysis

“…Overall, CRF improved with HT, and muscle strength increased with both HT and MERT. Similarly to previous meta‐analytic research, general RT improved these physical fitness components. As it might be assumed, AT led to superior improvement of CRF than HT and general RT, and HT, MERT and general RT showed more pronounced increases in muscle strength than AT.…”

“…Previous meta‐analyses have observed that RT characteristics did not (or scarcely) explain individually the between‐study heterogeneity in the magnitude of HbA1c, whereas the characteristics of patients with T2DM explained it slightly more. However, evidence about factors explaining between‐study variance on these clinical outcomes is almost inexistent.…”

“…HT, MERT, and general RT showed similar effects on these outcomes as AT, except for BMI and lean body mass, where AT and HT were more effective, respectively. Worryingly, clear discrepancies are appreciable regarding the effectiveness of RT on these outcomes, which might be explained by the methodological issues outlined in Appendix 1.…”

Slow movement resistance training using body weight improves muscle mass in the elderly: A randomized controlled trial

“…Sarcopenia, age‐related losses in the quantity of skeletal muscle mass as well as diminished muscle strength and/or physical performance, is associated with multiple adverse health consequences, including an increased risk of falls, fractures, and frailty, which can lead to a loss of independence and disability, increased morbidity and mortality, and reduced quality of life . In recent years, increasing attention has been paid to resistance training as a useful adjunctive tool for increasing muscle mass and strength . Resistance training programs in previous studies, however, required expensive exercise machines and supervised instruction .…”

“…[1][2][3] In recent years, increasing attention has been paid to resistance training as a useful adjunctive tool for increasing muscle mass and strength. [4][5][6] Resistance training programs in previous studies, however, required expensive exercise machines and supervised instruction. [5][6][7] For some elderly people, access to exercise facilities is limited and compliance may be poor.…”