Characteristics of treatment responses to physical exercise and diet in diabetic peripheral artery disease patients: a systematic review.
Qiang Wang, Ning Qian, Yijie Liu et al.
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In 30 seconds
This systematic review examined human studies of exercise and diet in people with diabetic peripheral artery disease (PAD). Of 18 included studies, 15 assessed exercise and three examined diet. Supervised and home-based exercise were reported to improve ankle-brachial index and blood-flow velocity, but effects on walking measures were absent or inconsistent. Mediterranean diet adherence was associated with blood flow, intermittent claudication, and PAD development risk. Evidence certainty ranged from very low to moderate for exercise outcomes and was low for diet-related findings.
Key findings
- Among 15 exercise studies, supervised and home-based exercise improved ankle-brachial index and blood-flow velocity.
- Walking outcomes, including six-minute walk distance and maximal walking time and distance, were not significantly improved or had conflicting results.
- Three diet studies linked Mediterranean diet adherence with blood flow, intermittent claudication, and risk of PAD development.
- GRADE certainty was very low to moderate for exercise findings and low for diet findings.
Why it matters
Exercise and dietary approaches are relevant to PAD management, but this review suggests that improvements in vascular measures may not translate consistently into better walking performance for people with diabetes. The low certainty of much of the evidence means these findings are best viewed as an overview of current evidence rather than definitive estimates of treatment benefit.
What to keep in mind
The review reports few studies, small sample sizes, moderate risk of bias, and conflicting results; evidence certainty was very low to moderate for exercise and low for diet.