Key result
Exercise training improves LV systolic and diastolic strain and mechanics in type 2 diabetes.
Why the study?
Patients with diabetes have an increased risk of heart failure with higher mortality, but study results regarding the effect of exercise on left ventricular function in type 2 diabetes mellitus are heterogeneous.
Does physical exercise training improve left ventricular systolic and diastolic function in adults with type 2 diabetes mellitus?
Systematic Review (n=314)
Does physical exercise training improve left ventricular systolic and diastolic function in adults with type 2 diabetes mellitus?
This systematic review of randomized trials suggests that regular physical exercise—particularly high-intensity intermittent training—can improve subclinical systolic and diastolic left ventricular dysfunction in patients with type 2 diabetes mellitus.
Answers are grounded in this paper and cite their sources.
Supports recommending exercise training in T2DM to improve subclinical LV function; confirms benefits across five RCTs.
Background: The incidence of diabetes mellitus in younger adults is rising over the years. The diabetic population has an increased risk of developing heart failure, and diabetic individuals with heart failure have four times greater mortality rate. Studies results about exercise effect on left ventricular function in type 2 diabetes mellitus are heterogenous. Objective : This review aimed to analyze the effects of physical exercise on left ventricular dysfunction in type 2 diabetes mellitus (T2DM). Methods: Only randomized clinical trials with humans published in English were included. Inclusion criteria were studies with type 2 diabetes patients, physical exercise, control group and left ventricular function. Exclusion criteria were studies with animals, children, teenagers, elderly individuals and athletes, presence of diet intervention, and patients with type 1 diabetes, cancer, cardiac, pulmonary, or neurological diseases. Electronic databases PubMed, Web of Science, Cochrane, and Scopus were last searched in September 2021. Risk of bias was assessed by the Physiotherapy Evidence Database (PEDro) scale. Results: Five studies were included, representing 314 diabetic individuals submitted to resistance and aerobic exercise training. Of the variables analyzed, physical exercise improved peak torsion (PTo), global longitudinal strain, global strain rate (GSR), time to peak untwist rate (PUTR), early diastolic filling rate (EDFR) and peak early diastolic strain rate (PEDSR). Conclusion: To our knowledge, this is the first systematic review on the effects of exercise on left ventricular function in T2DM including only randomized clinical trials with humans. Physical exercise seems to improve systolic and diastolic strain, twist, and torsion. High intensity exercise was reported to be superior to moderate intensity exercise in one study. This review was limited by the small number of studies and their heterogeneity regarding exercise protocols, follow-up period, exercise supervision and left ventricular function variables analyzed. This review was registered in PROSPERO (CRD42021234964).
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Petronilho et al. (2023) conducted a systematic review in Type 2 diabetes mellitus (n=314). Physical exercise training (aerobic and/or resistance exercise, moderate-intensity or high-intensity intermittent training) vs. Usual care (maintaining usual lifestyle with no change in medication, physical activity, or diet) was evaluated on Left ventricular systolic and diastolic function variables (including LVEF, S', GLS, GSR, PTo, e', E, E/e', E/A, EDFR, TPUTR, PEDSR). Physical exercise training improved systolic and diastolic left ventricular strain, twist, and torsion variables in 314 patients with type 2 diabetes across five randomized trials.
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