Ann Rehabil Med.  2021 Oct;45(5):345-358. 10.5535/arm.21102.

Home-Based Physical Activity in Patients With Type 2 Diabetes Mellitus: A Scoping Review

• Mustapa A
• Justine M
• Latir AA
• Manaf H

• KMID: 2521907
• DOI: http://doi.org/10.5535/arm.21102

Abstract

To promote optimal healthcare delivery in type 2 diabetes mellitus (T2DM) following the outbreak of coronavirus disease 2019, adopting home-based physical activity (PA) is being seriously considered. Therefore, this study aims to outline the characteristics of exercise protocols for home-based PA and the challenges and limitations in implementing home-based PA in patients with T2DM. This scoping review was carried out by identifying eligible studies in six different databases (Scopus, Cochrane Library, SpringerLink, ProQuest, Science Direct, and Google Scholar). The keywords used in the search strategies were: home-based physical activity, home-based exercise therapy, home-based physical exercise, home-based exercise, home-based exercise training, diabetes mellitus, and T2DM. Two reviewers independently screened all full-text articles to find articles that met the eligibility requirements. A total of 443 articles were identified in the search. Approximately 342 articles were excluded by screening titles and abstracts, which led to the selection of 44 articles relevant to the current study. Further screening of the full-text led to the subsequent removal of 34 other articles, leading to 10 studies that were eligible for data extraction. This review suggested that the exercise protocols for home-based PA include resistance exercise using free weight and own body weight with a frequency of two to three sessions per week at moderate intensity, along with aerobic exercise (particularly walking) with a frequency of three to five times per week at moderate intensity. A combination of resistance and aerobic exercise showed more significant benefits of PA in patients with T2DM. More studies regarding home-based PA in T2DM patients with metabolic disorders are warranted.

Keyword

Exercise, Physical activity, Resistance training, Diabetes mellitus type 2, Walking

Figure

• 

  Fig. 1. A Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) flow diagram. T1DM, type 1 diabetes mellitus; DPN, diabetic peripheral neuropathy.

Reference

1. Asiimwe D, Mauti GO, Kiconco R. Prevalence and risk factors associated with type 2 diabetes in elderly patients aged 45-80 years at Kanungu District. J Diabetes Res;2020; 2020:5152146.

2. Eller-Vainicher C, Cairoli E, Grassi G, Grassi F, Catalano A, Merlotti D, et al. Pathophysiology and management of type 2 diabetes mellitus bone fragility. J Diabetes Res. 2020; 2020:7608964.

3. World Health Organization W. Classification of diabetes mellitus. Geneva: World Health Organization;2019.

4. Baynes HW. Classification, pathophysiology, diagnosis and management of diabetes mellitus. J Diabetes Metab. 2015; 6:1–9.

5. International Diabetes Federation. IDF Diabetes Atlas. 9th ed. Brussels, Belgium: International Diabetes Federation Diabetes Atlas;2019.

6. Williams R, Karuranga S, Malanda B, Saeedi P, Basit A, Besancon S, et al. Global and regional estimates and projections of diabetes-related health expenditure: results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Res Clin Pract. 2020; 162:108072.

7. Cooper AR, Sebire S, Montgomery AA, Peters TJ, Sharp DJ, Jackson N, et al. Sedentary time, breaks in sedentary time and metabolic variables in people with newly diagnosed type 2 diabetes. Diabetologia. 2012; 55:589–99.

8. Falconer CL, Cooper AR, Walhin JP, Thompson D, Page AS, Peters TJ, et al. Sedentary time and markers of inflammation in people with newly diagnosed type 2 diabetes. Nutr Metab Cardiovasc Dis. 2014; 24:956–62.

9. Balducci S, Coccia EM. Sedentariness and physical activity in type 2 diabetes during the COVID-19 pandemic. Diabetes Metab Res Rev. 2021; 37:e3378.

10. Lim S, Bae JH, Kwon HS, Nauck MA. COVID-19 and diabetes mellitus: from pathophysiology to clinical management. Nat Rev Endocrinol. 2021; 17:11–30.

11. Duclos M, Oppert JM, Verges B, Coliche V, Gautier JF, Guezennec Y, et al. Physical activity and type 2 diabetes. Recommandations of the SFD (Francophone Diabetes Society) diabetes and physical activity working group. Diabetes Metab. 2013; 39:205–16.

12. Diabetes Canada Clinical Practice Guidelines Expert Committee, Sigal RJ, Armstrong MJ, Bacon SL, Boule NG, Dasgupta K, et al. Physical activity and diabetes. Can J Diabetes. 2018; 42 Suppl 1:S54–63.

13. American Diabetes Association. 2. Classification and diagnosis of diabetes: Standards of Medical Care in Diabetes-2020. Diabetes Care. 2020; 42(Suppl 1):S14–31.

14. Thomas N, Alder E, Leese GP. Barriers to physical activity in patients with diabetes. Postgrad Med J. 2004; 80:287–91.

15. Sanghamitra P, Eunice L, Sandipana P, Shayma D, Pranab M. Type 2 diabetes and physical activity: Barriers and enablers to diabetes control in Eastern India. Prim Health Care Res Dev. 2019; 20:e44.

16. Duclos M, Dejager S, Postel-Vinay N, di Nicola S, Quere S, Fiquet B. Physical activity in patients with type 2 diabetes and hypertension: insights into motivations and barriers from the MOBILE study. Vasc Health Risk Manag. 2015; 11:361–71.

17. Grabia M, Markiewicz-Zukowska R, Puscion-Jakubik A, Bielecka J, Nowakowski P, Gromkowska-Kepka K, et al. The nutritional and health effects of the COVID-19 pandemic on patients with diabetes mellitus. Nutrients. 2020; 12:2013.

18. Rastogi A, Hiteshi P, Bhansali A. Improved glycemic control amongst people with long-standing diabetes during COVID-19 lockdown: a prospective, observational, nested cohort study. Int J Diabetes Dev Ctries. 2020; 1–6.

19. Ruiz-Roso MB, Knott-Torcal C, Matilla-Escalante DC, Garcimartin A, Sampedro-Nunez MA, Davalos A, et al. COVID-19 lockdown and changes of the dietary pattern and physical activity habits in a cohort of patients with type 2 diabetes mellitus. Nutrients. 2020; 12:2327.

20. Aylin K, Arzu D, Sabri S, Handan TE, Ridvan A. The effect of combined resistance and home-based walking exercise in type 2 diabetes patients. Int J Diabetes Dev Ctries. 2009; 29:159–65.

21. Dunstan DW, Daly RM, Owen N, Jolley D, Vulikh E, Shaw J, et al. Home-based resistance training is not sufficient to maintain improved glycemic control following supervised training in older individuals with type 2 diabetes. Diabetes Care. 2005; 28:3–9.

22. Ferrer-Garcia JC, Sanchez Lopez P, Pablos-Abella C, Albalat-Galera R, Elvira-Macagno L, Sanchez-Juan C, et al. Benefits of a home-based physical exercise program in elderly subjects with type 2 diabetes mellitus. Endocrinol Nutr. 2011; 58:387–94.

23. Arksey H, O’Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005; 8:199–32.

24. Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018; 169:467–73.

25. Cheung NW, Cinnadaio N, Russo M, Marek S. A pilot randomised controlled trial of resistance exercise bands in the management of sedentary subjects with type 2 diabetes. Diabetes Res Clin Pract. 2009; 83:e68–71.

26. Dadgostar H, Firouzinezhad S, Ansari M, Younespour S, Mahmoudpour A, Khamseh ME. Supervised groupexercise therapy versus home-based exercise therapy: their effects on Quality of Life and cardiovascular risk factors in women with type 2 diabetes. Diabetes Metab Syndr. 2016; 10(2 Suppl 1):S30–6.

27. Krousel-Wood MA, Berger L, Jiang X, Blonde L, Myers L, Webber L. Does home-based exercise improve body mass index in patients with type 2 diabetes? Results of a feasibility trial. Diabetes Res Clin Pract. 2008; 79:230–6.

28. Liu Y, Liu SX, Cai Y, Xie KL, Zhang WL, Zheng F. Effects of combined aerobic and resistance training on the glycolipid metabolism and inflammation levels in type 2 diabetes mellitus. J Phys Ther Sci. 2015; 27:2365–71.

29. Plotnikoff RC, Eves N, Jung M, Sigal RJ, Padwal R, Karunamuni N. Multicomponent, home-based resistance training for obese adults with type 2 diabetes: a randomized controlled trial. Int J Obes (Lond). 2010; 34:1733–43.

30. Rekha K, Anandh V, Rajendran K. Home based therapeutic intervention for type 2 diabetes mellitus. J Chem Pharm Sci. 2014; 7:275–280.

31. Shinji S, Shigeru M, Ryusei U, Mitsuru M, Shigehiro K. Adherence to a home-based exercise program and incidence of cardiovascular disease in type 2 diabetes patients. Int J Sports Med. 2007; 28:877–9.

32. McGinley SK, Armstrong MJ, Boule NG, Sigal RJ. Effects of exercise training using resistance bands on glycaemic control and strength in type 2 diabetes mellitus: a meta-analysis of randomised controlled trials. Acta Diabetol. 2015; 52:221–30.

33. Marwick TH, Hordern MD, Miller T, Chyun DA, Bertoni AG, Blumenthal RS, et al. Exercise training for type 2 diabetes mellitus: impact on cardiovascular risk: a scientific statement from the American Heart Association. Circulation. 2009; 119:3244–62.

34. Klimek M, Knap J, Masternak M, Reda M. Physical activity in prevention and treatment of type 2 diabetes mellitus. J Educ Health Sport. 2019; 9:1175–81.

35. Moghetti P, Balducci S, Guidetti L, Mazzuca P, Rossi E, Schena F, et al. Walking for subjects with type 2 diabetes: a systematic review and joint AMD/SID/SISMES evidence-based practical guideline. Nutr Metab Cardiovasc Dis. 2020; 30:1882–98.

36. Oliveira C, Simoes M, Carvalho J, Ribeiro J. Combined exercise for people with type 2 diabetes mellitus: a systematic review. Diabetes Res Clin Pract. 2012; 98:187–98.

37. Cuff DJ, Meneilly GS, Martin A, Ignaszewski A, Tildesley HD, Frohlich JJ. Effective exercise modality to reduce insulin resistance in women with type 2 diabetes. Diabetes Care. 2003; 26:2977–82.

38. Ginszt A, Ginszt M, Majcher P, Tarkowski Z. Effects of exercise on blood glucose levels in type 2 diabetic patients: literature review. Polish Ann Med. 2018; 25:272–6.

39. Esteves M, Gouveia A, Rodrigues R, Pinheiro P, Bras R, O’Hara K, et al. Supervised exercise patterns among diabetic and non-diabetic Portuguese adults. Ann Appl Sport Sci. 2019; 7:49–56.

40. Karatay G, Akkus Y, Ozturk B, Sulu B. The effectiveness of a home-based diabetes management program on diabetes control. Arch Prev Med. 2016; 1:015–020.

41. Advika TS, Idiculla J, Kumari SJ. Exercise in patients with type 2 diabetes: facilitators and barriers: a qualitative study. J Family Med Prim Care. 2017; 6:288–92.

42. Peters MD, Godfrey CM, Khalil H, McInerney P, Parker D, Soares CB. Guidance for conducting systematic scoping reviews. Int J Evid Based Healthc. 2015; 13:141–6.