Effectiveness Of Seven Categories Of Aerobic Exercise Therapies For Type 2 Diabetes-A Network Meta-Analysis

Background: Diabetes mellitus(DM)is one of the most serious and critical health problems facing the world in the 21 st century.Aerobic exercise therapy is one of the most commonly used treatment methods in rehabilitation nursing of type 2 diabetes mellitus(T2DM),and plays an important role in controlling blood glucose and blood fat.Objective: To compare the effects of seven categories of aerobic exercise therapies(Baduanjin,Taiji,square dance,yoga,vigorous walk,running and soccer)on blood glucose and blood fat in T2 DM,and to summarize the experience and find out the best aerobic exercise therapies which are safe,effective and easy to operate.The aim is to improve the knowledge system of exercise intervention in T2 DM and provide evidence-based medicine for rehabilitation nursing of T2 DM.Methods: Randomized controlled trials of seven categories of aerobic exercise in the treatment of T2 DM were retrieved by computer from CINAHL,PUBMED,EMbase,Cochrane Library,CBMdisc,CNKI,VIP,Wan Fang and Pro Quest databases.As of August 2018,data were extracted and evaluated by the literature quality evaluation method of the Cochrane Systematic Review Manual.Statistical analysis was carried out by R software.Results: A total of 36 RCTs were included,totaling 2461 patients with T2 DM.The results of network meta-analysis ranked by SUCRA showed that the average ranking of blood glucose related indicators(FBG,Hb A1c)was conventional therapy + yoga(SUCRA = 89.7),conventional therapy + Baduanjin(64.7),conventional therapy + vigorous walk(54.3),conventional therapy + Taiji(52.3),conventional therapy + running(43.6),conventional therapy + soccer(35.8),conventional therapy + square dance(31.5)and conventional therapy(7.6);In the blood fat related indicators(TC,TG,HDL,LDL),the average ranking of the four indicators is conventional therapy + vigorous walk(SUCRA = 70.9),conventional therapy + Taiji(62.725),conventional therapy + yoga(54.125),conventional therapy + Baduanjin(52.075),conventional therapy + square dance(51.55),conventional therapy + running(43.5).825),conventional therapy + soccer(40.2)and conventional therapy(24.575).Sensitivity analysis shows that the ranking results are basically consistent with the overall ranking results,suggesting that the results are stable and reliable.Conclusion: Seven categories of aerobic exercise therapies combined with conventional therapy are better than simple conventional therapy in patients with T2 DM.Conventional therapy + yoga may be a better aerobic exercise choice for improving blood glucose in patients with T2 DM.Conventional therapy + vigorous walk may be a better aerobic exercise choice for improving blood fat in patients with T2 DM.Conventional therapy + traditional exercise therapy(Taiji and Baduanjin)can improve blood glucose and blood fat in patients with T2 DM and those rankings were stable at the middle level.However,due to the existence of heterogeneity and bias risk,the application of ranking results should be further validated in clinical practice.