The Role of Physical Counselling in Patients with Type 2 Diabetes Mellitus: A Systematic Review

Abstract

Context: Physical exercise is a key component of treatment and management of people with Type 2 Diabetes, but the role of strategies and interventions to increase and promote physical activity is unclear. Objective: To conduct a systematic review of intervention studies assessing the effects of physical activity counselling on health outcomes in subjects with type 2 diabetes mellitus. Data sources: The Cochrane Library, MEDLINE, EMBASE, CINAHL, LILACS, ClinicalTrials.gov databases were used for the literature search. Data Selection: Studies that assessed the effects of interventions mainly based on physical activity counselling strategies, on physical activity level and glycosylated hemoglobin (HbA1c) were included in the review. Data Extraction: Two independent reviewers extracted the data. Data Synthesis: A total of 23 studies out of 1425 retrieved from databases search, were included in the review. The global number of subjects included in the selected studies was 9913, and the mean age of participants was 58.8 (±8.2) years (min = 46.3; max = 73.6). The most part of the studies (19) reported values of physical activity level; 13 of them (68.4%) found a significant effect after the counselling intervention, while 6 (31.6%) did not found significant changes. Among the 17 studies reporting data on HbA1c 9 (52.9%) described a significant decrease in the counselling intervention group, while 7 (41.2%) did not find any statistically significant change and 1 (5.9%) reported a significant HbA1c reduction in the comparison group rather than the counselling group. Conclusions: The results presented in this systematic review seem to affirm the usefulness of physical counselling interventions on physical activity and HbA1c, however the lack of homogeneity in the intervention protocols and the contrasting results limit the comprehension of the usefulness of such an approach in patient with type 2 diabetes.