Review Article

Physical Exercise on Inflammatory Markers in Type 2 Diabetes Patients: A Systematic Review of Randomized Controlled Trials

Table 2

Description of training programs employed in the treatment of participants in randomized clinical trials.

Author, yearCountryParticipantsInterventions, group ()Intervention periodInflammatory status variables analyzedResultsRemarks

Brooks et al., 2007 [20]United StatesHispanic man and woman, 55 years old and older with diagnosed T2DMControl (31): recommended to continue usual standard of care.
Resistance (31): 60–80% of 1RM during the first 9 weeks and 70–80% of 1RM on weeks 10–16.
45 min/session,
3x/week,
for 4 months
CRP (mg/l)
Adiponectin (µg/ml)
Reduction in serum CRP level in resistance training group compared with control group.
Increase in adiponectin concentrations in resistance group compared with control group.
Data from CRP and adiponectin were exposed as median and interquartile range.

Kadoglou et al., 2007 [26]GreeceMan and woman
with diagnosed
T2DM
Control (30): no programmed activity.
Aerobic (30): 50–75% of maximum O2 consumption.
60 min/session,
4x/week,
for 6 months
hsCRP (mg/dl)
Adiponectin (μg/ml)
TNF-α (pg/ml)
Interleukin-18
(pg/ml)
Interleukin-10
(pg/ml)
Reduction in hsCRP and interleukin-18 after aerobic training compared with control group.
Increase in interleukin-10 after aerobic training compared with control group.
Nonsignificant changes in TNF-α or adiponectin in either group or between the groups after the intervention.
Data from hsCRP,
adiponectin, TNF-α,
interleukin-10, and interleukin-18 were exposed on graphs without values of mean and standard deviation.

Oberbach et al., 2008 [21]GermanyMan and woman
with glucose
impaired tolerance
Control (16): not described.
Aerobic (24): load not described.
60 min/session,
2x/week,
for 12 months
hsCRP (pg/ml)
Interleukin-6
(pg/ml)
Reduction in hsCRP and interleukin-6 serum level in the aerobic group after intervention.Data before and after intervention
exposed on analytical values
(mean ± standard error of mean).

Jorge et al., 2011 [22]BrazilMan and woman
aged 30–70 years
diagnosed with T2DM and with body mass index between 25 and 40 kg/m2
Control (12): light stretching exercise.
Aerobic (12): up to lactate threshold.
Resistance (12): load not described.
Combination (12): aerobic and resistance training with the same intensity of the other training groups and half of the exercise volume on each category.
60 min/session,
3x/week,
for 3 months
hsCRP (mg/ml)
Adiponectin
(μg/ml)
Visfatin (ng/ml)
Resistin (ng/ml)
TNF-α (pg/ml)
Interleukin -6
(pg/ml)
Reduction in hsCRP serum level in all groups, including control after intervention.
Increase in visfatin serum level in all groups, including control after intervention.
Nonsignificant changes in adiponectin, resistin,
TNF-α, or interleukin-6 in either group after intervention.
Data before and after intervention exposed on analytical values (mean ± standard deviation).

Kadoglou et al., 2012 [23]GreeceMan and woman
aged 50–70 years
with a diagnosis of T2DM
Control (27): 150 minutes/week of self-managed physical activity.
Aerobic (26): progressive load until 60%–75% of .  
60 min/session,
4x/week,
for 3 months
Human apelin-12
(ng/ml)
Ghrelin (ng/ml)
Increment on apelin serum level after the intervention period on aerobic training group compared with control group.
Nonsignificant effect on ghrelin serum level in the intervention group.
Data from apelin and ghrelin were exposed on graphs without values of mean and standard deviation.

Kadoglou et al., 2012 [27]GreeceMan and woman with T2DM diagnosed for more than 1 yearControl (24): 150 minutes/week of self-managed physical activity.
Resistance (23): 2-3 sets of 6–8 repetitions on machine weights. Exercise intensity of 60–80% of 1RM.
60 min/session,
3x/week,
for 3 months
hsCRP (mg/l)Nonsignificant changes in CRP levels between the groups after the intervention.Data expressed as delta variation (mean ± standard deviation).

Sukala et al., 2012 [24]New ZealandMan and woman
self-identified
Polynesian
descent, with clinical diagnosis of T2DM and visceral obesity
Aerobic (9): 65–80% of heart rate reserve ().
Resistance (9): progressive load (5%) starting from the execution of 10 repetitions.
40 to 60 min/session,
3x/week,
for 4 months
CRP (log)
Adiponectin
(μg/ml)
Nonsignificant changes in CRP or adiponectin in either group or between the groups after the intervention.Data expressed as delta variation (mean ± standard deviation).

Swift et al., 2012 [28]United StatesMan and woman aged 35–70 years
with diagnosed
T2DM
Control (37): weekly stretching and relaxation.
Aerobic (50): 50–80% of maximum O2 consumption.
Resistance (58): progressive load starting from the execution of 12 repetitions.
Combination (59): combination of aerobic training (10 kcal/kg/week) plus 2 sessions of resistance training per week.
150 min/week,
3x/week,
for 9 months
CRP (mg/l)Nonsignificant change in CRP serum level in either group or between the groups after the intervention.Data expressed as delta variation
(mean ± confidence interval).

Kadoglou et al., 2013 [29]GreeceMan and woman with T2DM diagnosed
for more than 1
year.
Control (24): 150 minutes/week of self-managed physical activity.
Aerobic (21): progressive load until 60%–75% of .  
Resistance (23): load of 60%–80% of 1-MR.
Combination (22): aerobic and resistance training with the same intensity of the other training groups and half of the exercise volume on each category.
60 min/session,
4x/week,
for 6 months
hsCRP (mmol/l)
Vaspin (ng/ml)
Human apelin-12
(ng/ml)
Visfatin (ng/ml)
Ghrelin (ng/ml)
Reduction in hsCRP and visfatin serum level after aerobic and combined training compared with both resistance training alone and control groups.
Increment on apelin and vaspin serum level in the aerobic exercise and combined groups rather than in the control and resistance training groups.
Nonsignificant effect on ghrelin serum level in the intervention groups.
Data from vaspin,
apelin, visfatin, and ghrelin were exposed on graphs without values of mean and standard deviation.

Moghadasi et al., 2013 [30]IranObese and overweight man with T2DMControl (8): not described.
Aerobic (8): 40–59% of maximum O2 consumption.
30 min/session,
4x/week,
for 3 months
hsCRP (mg/ml)
Adiponectin (µg/l)
Nonsignificant changes
in CRP in either group or between the groups after the intervention.
Adiponectin level increased in training group compared with pretraining values.

Mavros et al., 2014 [25]AustraliaMan and woman ≥60 years of age, sedentary with type 2 diabetes and metabolic syndromeControl (47): training on the same equipment used by resistance group, 3 times a week, under supervision from the same trainers. Exercise intensity as low as possible and not progressing.
Resistance (41): 3 sets of 8 repetitions. Exercise intensity of 80% of 1RM.
Session duration not informed,
3x/week, for 12 months
CRP (mg/l)Reduction in CRP in resistance group relative to control group.