A Systematic Review and Meta-Analysis on the Effectiveness of Aerobic Exercise and Diet for Individuals with Type 2 Diabetes and Obesity

Abstract

Abstract Background Lifestyle changes involving diet and exercise are recommended for patients diagnosed with obesity and type 2 diabetes mellitus (T2DM). However, the effectiveness of combining aerobic exercise and diet (AEDT) in obese T2DM patients has not been studied in a systematic review and meta-analysis. Therefore, the purpose of this review was to systematically evaluate the effects of AEDT on individuals with obesity and T2DM. Methodology: A comprehensive search of the PubMed, Web of Science, Scopus, Science Direct, Cochrane, and Google Scholar databases was conducted for this meta-analysis. Statistical analysis was performed using the random effects model for continuous variables, and the results were presented as mean differences (MD) or standardized mean difference (SMD) with 95% confidence intervals (CI). Results Out of the 16,129 studies identified, 15 trials involving a total of 2,454 patients were included in the meta-analysis. The findings revealed significant reductions in body mass index, body weight, waist circumference, systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), triglyceride levels, glycated hemoglobin (HbA1c), fasting blood glucose, fasting plasma insulin, leptin, interleukin-6 (IL-6), and C-reactive protein (CRP) (p < 0.005) compared to the standard treatment (ST) group. On the other hand, there was a significant increase in adiponectin levels in response to AEDT (p < 0.005). However, when evaluating obesity-related factors, no significant differences were observed between the AEDT and ST groups for parameters such as fat mass, hip circumference, waist-to-hip ratio, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and tumor necrosis factor-alpha (TNF-α) (p > 0.05). Conclusions AEDT could be considered an additional therapy in conjunction with conventional clinical treatments due to its significant positive impact on obese T2DM patients. Nevertheless, further robust evidence is necessary to determine whether AEDT is an effective intervention for reducing the need for aggressive pharmacological approaches in individuals with obesity and T2DM.