Physical activity and change in fasting glucose and HbA1c: a quantitative meta-analysis of randomized trials
A systematic review was conducted of randomized trials which evaluated the impact of physical activity on the change in fasting glucose and HbA1c.
A literature search was conducted in PubMed until December 2015. Studies reporting glucose or HbA1c at baseline and at the end of study were included, and the change and its variance were estimated from studies with complete data. Mixed-effect random models were used to estimate the change of fasting glucose (mg/dl) and HbA1c (%) per additional minutes of physical activity per week.
A total of 125 studies were included in the meta-analysis. Based on 105 studies, an increase of 100 min in physical activity per week was associated with an average change of −2.75 mg/dl of fasting glucose (95% CI −3.96; −1.55), although there was a high degree of heterogeneity (83.5%). When restricting the analysis on type 2 diabetes and prediabetes subjects (56 studies), the average change in fasting glucose was −4.71 mg/dl (95% CI −7.42; −2.01). For HbA1c, among 76 studies included, an increase of 100 min in physical activity per week was associated with an average change of −0.14% of HbA1c (95% CI −0.18; −0.09) with heterogeneity (73%). A large degree of publication bias was identified (Egger test p < 0.001). When restricting the analysis on type 2 diabetes and prediabetes subjects (60 studies), the average change in HbA1c was −0.16% (95% CI −0.21; −0.11).
This analysis demonstrates that moderate increases in physical activity are associated with significant reductions in both fasting glucose and HbA1c.
KeywordsDiabetes Physical activity Exercise Fasting glucose Glycated hemoglobin Meta-analysis
Exercise and Sports Science Australia
Type 1 diabetes mellitus
Type 2 diabetes mellitus
Weighted mean difference
The authors thank Magali Boniol, International Prevention Research Institute, for help with data extraction verifications.
This work was funded by the International Prevention Research Institute.
MB designed the study, MD did the literature search and data collection, and MB and MD analyzed the data. All authors interpreted the results, edited and revised the manuscript, and approved the final manuscript as submitted.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
Human and animal rights
This article does not contain any studies with human or animal subjects performed by the any of the authors.
Informed consent was obtained from all participants in this study.
- 1.World Health Organization (2010) Global recommendations on physical activity for health. World Health Organization, GenevaGoogle Scholar
- 11.Balducci S, Zanuso S, Nicolucci A et al (2010) Effect of an intensive exercise intervention strategy on modifiable cardiovascular risk factors in subjects with type 2 diabetes mellitus: a randomized controlled trial: the Italian Diabetes and Exercise Study (IDES). Arch Intern Med 170:1794–1803CrossRefPubMedGoogle Scholar
- 12.Sigal RJ, Alberga AS, Goldfield GS et al (2014) Effects of aerobic training, resistance training, or both on percentage body fat and cardiometabolic risk markers in obese adolescents: the healthy eating aerobic and resistance training in youth randomized clinical trial. JAMA Pediatr 168:1006–1014CrossRefPubMedGoogle Scholar
- 24.Garber CE, Blissmer B, Deschenes MR et al (2011) American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc 43:1334–1359CrossRefPubMedGoogle Scholar
- 25.Oehlert GW (1992) A Note on the Delta Method. Am Stat 46:27–29Google Scholar