Effects of Baduanjin Exercise on Glucose and Lipid Metabolism in Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis
Authors: Guo Meixuan , Cai Mengyuan , Wang Hui , Hu Zhipeng , Feng Haoyue , Xie Chunguang 
Published: March 2023

Background: Type 2 diabetes mellitus (T2DM) refers to a metabolic disorder characterized by persistent hyperglycemia. Uncontrolled blood glucose levels over time may lead to serious complications, possibly even death. As an adjunctive treatment for T2DM, increasing numbers of clinical studies have demonstrated that Baduanjin (the Eight Section Brocades)—one of Traditional Asian exercise may effectively control fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), and 2h postprandial plasma glucose (P2hPG) as well as blood lipid levels of diabetic patients. However, the primary evidence demonstrating the clinical benefit of Baduanjin exercise in diabetic patients remains insufficient, especially the intervention effect on glucose and lipid metabolism is not fully understood. Objectives: The purpose of this study is to examine the effects of Baduanjin exercise on glucose and lipid metabolism in individuals with type 2 diabetes in randomized controlled trials (RCTs). Methods: Nine electronic databases were searched from the database’s inception until January 31th, 2023, without regard to language constraints (PubMed, Web of Science, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform (WAN FANG), VIP information resource integration service platform (CQVIP) and China Biology Medicine (CBM)). Furthermore, information concerning unpublished or continuing clinical trials was searched within the National Institutes of Health clinical registry Clinical Trials, the International Clinical Trials Registry Platform, and the Chinese Clinical Trials Registry. RCTs that examined the effect of Baduanjin exercise on glucose and lipid metabolism were identified. The primary outcomes of this study were fasting plasma glucose (FPG), 2h postprandial plasma glucose (P2hPG) and glycosylated hemoglobin (HbA1c). The literature was chosen based on inclusion and exclusion criteria, with the Baduanjin exercise serving as the primary method for the experimental group. Selection, data collection and extraction of studies were conducted separately by at least two reviewers, with disagreements resolved through discussion. The mean difference (MD) with a 95% confidence interval (CI) was employed for continuous outcomes. Analysis of data and subgroups, as well as sensitivity analysis, were performed utilizing Review Manager V.5.4.1 (RevMan V.5.4.1) and Stata/MP 17.0. Results: This meta-analysis comprised twenty-six original studies with 1,779 individuals. Glucose metabolism: As a result of the pooled analysis, it demonstrated that combination treatment resulted in a reduction in the HbA1c (MD: -0.73, 95% CI: -0.91 to -0.55, P<0.00001), FPG (MD −1.14, 95% CI −1.38 to −0.90, P<0.00001), P2hPG (MD: -1.22, 95% CI: -1.66 to -0.78, P<0.00001), Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) (MD: -0.59, 95% CI: -1.07 to -0.11, P＝0.02), and Fasting Insulin (FINS) (MD: -2.63, 95% CI: -3.81 to -1.45, P<0.0001). Lipid metabolism: The results revealed that Baduanjin exercise could help T2DM patients improving the level of lipid metabolism, which reduced the level of Total cholesterol (TC) (MD: -0.36, 95% CI: -0.52 to -0.21, P<0.00001), Triglycerides (TG) (MD: -0.56, 95% CI: -0.82 to -0.30, P<0.0001), Low density lipoprotein (LDL-C) (MD: -0.19, 95% CI: -0.29 to -0.10, P＝0.0001) and increased the level of High-density lipoprotein (HDL-C) (MD: 0.11, 95% CI: 0.06 to 0.16, P<0.0001). Simultaneously, the combined findings also demonstrated that the interventions were efficacious in decreasing Body Mass Index (BMI) (MD: -1.14, 95% CI: -1.90 to -0.37, P＝0.004) and Waist-Hip Ratio (WHR) (MD: -0.07, 95% CI: -0.13 to -0.01, P＝0.02). Sensitivity analyses indicated that these results were robust. Conclusions: Current low-quality evidence demonstrated that T2DM patients through Baduanjin exercise could significantly improve the level of glucose and lipid metabolism. The evidence available was insufficient to establish the effects of Baduanjin exercise on T2DM patients. Further high-quality studies are needed to explore its effects of Baduanjin exercise on T2DM patients. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/display_record.php?Record ID=325538.