PDM: Prediabetes (2013)

PDM: Prediabetes (2013)

• Assessment
  In individuals with prediabetes, what is the impact of physical activity, independent of weight loss and dietary change, on glycemic-related outcomes (such as fasting blood glucose, random blood glucose, 2-hour post prandial blood glucose, A1C)?

  • Conclusion

    Most studies report that moderate intensity physical activity, independent of weight loss and dietary change, has no significant impact on fasting blood glucose levels in individuals with prediabetes.

    In addition, limited research reports mixed results regarding the impact of moderate intensity physical activity on two-hour post-prandial blood glucose.

    Of two intervention studies reporting A1C values, both reported no significant effect of moderate-intensity physical activity.

    Additional longer-term intervention studies are needed to ascertain an effect of physical activity on glycemic-related outcomes in individuals with prediabetes.

  • Grade: II
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In individuals with prediabetes, what is the impact of physical activity, independent of weight loss and dietary change, on glycemic-related outcomes (such as fasting blood glucose, random blood glucose, two-hour post-prandial blood glucose, A1C)?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Black LE, Swan PD, Alvar BA. Effects of intensity and volume on insulin sensitivity during acute bouts of resistance training. J Strength Cond Res. 2010; 24(4): 1,109-1,116.
      • Desch S, Sonnabend M, Niebauer J, Sixt S, Sareban M, Eitel I, de Waha S, Thiele H, Bluher M, Schuler G. Effects of physical exercise versus rosiglitazone on endothelial function in coronary artery disease patients with prediabetes. Diabetes Obes Metab. 2010; 12(9): 825-828.
      • Melton CE, Tucker PS, Fisher-Wellman KH, Schilling BK, Bloomer RJ. Acute exercise does not attenuate postprandial oxidative stress in prediabetic women. Phys Sportsmed. 2009; 37(1): 27-36.
      • Sixt S, Rastan A, Desch S, Sonnabend M, Schmidt A, Schuler G, Niebauer J. Exercise training but not rosiglitazone improves endothelial function in prediabetic patients with coronary disease. Eur J Cardiovasc Prev Rehabil. 2008; 15(4): 473-478.
      • van Dijk JW, Manders RJ, Tummers K, Bonomi AG, Stehouwer CD, Hartgens F, van Loon LJ. Both resistance- and endurance-type exercise reduce the prevalence of hyperglycaemia in individuals with impaired glucose tolerance and in insulin-treated and non-insulin-treated type 2 diabetic patients. Diabetologia. 2012; 55(5): 1,273-1,282.
      • Yates T, Davies M, Gorely T, Bull F, Khunti K. Effectiveness of a pragmatic education program designed to promote walking activity in individuals with impaired glucose tolerance: A randomized controlled trial. Diabetes Care. 2009; 32: 1,404-1,410.
      • Yates T, Davies MJ, Sehmi S, Gorely T, Khunti K. The Pre-diabetes Risk Education and Physical Activity Recommendation and Encouragement (PREPARE) programme study: Are improvements in glucose regulation sustained at 2 years? Diabet Med. 2011; 28(10); 1,268-1,271.
  • Search Plan and Results: PDM: Physical Activity and Prediabetes 2012
     
  In individuals with prediabetes, what is the impact of physical activity, independent of weight loss and dietary change, on lipid outcomes (TG, HDL)?

  • Conclusion

    Limited research reports mixed results regarding the impact of moderate intensity physical activity, independent of weight loss and dietary change, on triglyceride levels in individuals with prediabetes.

    Intervention studies reported no significant impact of moderate intensity physical activity on HDL cholesterol levels.

    Additional longer-term intervention studies are needed to ascertain an effect of physical activity on lipid outcomes in individuals with prediabetes.

  • Grade: II
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In individuals with prediabetes, what is the impact of physical activity, independent of weight loss and dietary change, on lipid outcomes (TG, HDL)?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Desch S, Sonnabend M, Niebauer J, Sixt S, Sareban M, Eitel I, de Waha S, Thiele H, Bluher M, Schuler G. Effects of physical exercise versus rosiglitazone on endothelial function in coronary artery disease patients with prediabetes. Diabetes Obes Metab. 2010; 12(9): 825-828.
      • Melton CE, Tucker PS, Fisher-Wellman KH, Schilling BK, Bloomer RJ. Acute exercise does not attenuate postprandial oxidative stress in prediabetic women. Phys Sportsmed. 2009; 37(1): 27-36.
      • Sixt S, Rastan A, Desch S, Sonnabend M, Schmidt A, Schuler G, Niebauer J. Exercise training but not rosiglitazone improves endothelial function in prediabetic patients with coronary disease. Eur J Cardiovasc Prev Rehabil. 2008; 15(4): 473-478.
      • Yates T, Davies M, Gorely T, Bull F, Khunti K. Effectiveness of a pragmatic education program designed to promote walking activity in individuals with impaired glucose tolerance: A randomized controlled trial. Diabetes Care. 2009; 32: 1,404-1,410.
  • Search Plan and Results: PDM: Physical Activity and Prediabetes 2012
     
  In individuals with prediabetes, what is the impact of physical activity, independent of weight loss and dietary change, on anthropometric outcomes (WC, WHR)?

  • Conclusion

    Limited research reports that moderate-intensity physical activity, independent of weight loss and dietary change, has no significant impact on waist circumference in individuals with prediabetes.

    Additional longer-term intervention studies are needed to ascertain an effect of physical activity on anthropometric outcomes in individuals with prediabetes.

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In individuals with prediabetes, what is the impact of physical activity, independent of weight loss and dietary change, on anthropometric outcomes (WC, WHR)?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Yates T, Davies M, Gorely T, Bull F, Khunti K. Effectiveness of a pragmatic education program designed to promote walking activity in individuals with impaired glucose tolerance: A randomized controlled trial. Diabetes Care. 2009; 32: 1,404-1,410.
      • Yates T, Davies MJ, Sehmi S, Gorely T, Khunti K. The Pre-diabetes Risk Education and Physical Activity Recommendation and Encouragement (PREPARE) programme study: Are improvements in glucose regulation sustained at 2 years? Diabet Med. 2011; 28(10); 1,268-1,271.
  • Search Plan and Results: PDM: Physical Activity and Prediabetes 2012
     
  In individuals with prediabetes, what is the impact of physical activity, independent of weight loss and dietary change, on blood pressure?

  • Conclusion

    Limited research reports that moderate intensity physical activity, independent of weight loss and dietary change, has no significant impact on systolic or diastolic blood pressure in individuals with prediabetes.

    Additional longer-term intervention studies are needed to ascertain an effect of physical activity on blood pressure in individuals with prediabetes.

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In individuals with prediabetes, what is the impact of physical activity, independent of weight loss and dietary change, on blood pressure?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Desch S, Sonnabend M, Niebauer J, Sixt S, Sareban M, Eitel I, de Waha S, Thiele H, Bluher M, Schuler G. Effects of physical exercise versus rosiglitazone on endothelial function in coronary artery disease patients with prediabetes. Diabetes Obes Metab. 2010; 12(9): 825-828.
      • Yates T, Davies M, Gorely T, Bull F, Khunti K. Effectiveness of a pragmatic education program designed to promote walking activity in individuals with impaired glucose tolerance: A randomized controlled trial. Diabetes Care. 2009; 32: 1,404-1,410.
  • Search Plan and Results: PDM: Physical Activity and Prediabetes 2012