Exercício físico supervisionado remotamente em indivíduos com Diabetes Mellitus tipo 2: evidências de uma revisão sistemática e um ensaio clínico randomizado

Abstract

This dissertation presents the results of two studies that investigated the effects of remotely supervised physical exercise interventions in individuals with type 2 diabetes mellitus (T2DM). The first study, a systematic review of the literature, aimed to evaluate the clinical efficacy of remotely supervised exercise programs on glycemic control, cardiorespiratory fitness, quality of life (QoL), and blood pressure in individuals with T2DM, as well as to synthesize the methodological characteristics of the included studies. The review involved searches in the PubMed, Embase, Scopus, Web of Science, and SciELO databases, resulting in the inclusion of four studies comprising 263 participants who underwent 6- to 8-week interventions involving aerobic, resistance, breathing, and/or balance exercises. The findings indicated improvements in glycemic control across all studies, along with enhanced cardiorespiratory fitness and QoL in three of them. None of the studies assessed blood pressure, highlighting a methodological gap. The second study, a randomized clinical trial, aimed to evaluate the effects of a 12-week remotely supervised physical exercise program on QoL, sleep quality (SQ), depressive symptoms (DS), and diabetes-related emotional distress (DRED) in individuals with T2DM. Thirty-three participants were randomly allocated to an intervention group (IG), which underwent remotely supervised combined training, and a control group (CG), which received physical activity guidance via WhatsApp. Outcome assessments were conducted using validated online questionnaires, and data were analyzed using Generalized Estimating Equations with Bonferroni post hoc tests. The results demonstrated a significant improvement in SQ in the IG (p = 0.036) and an improvement in QoL over time in both groups (p < 0.001), with no statistically significant changes in DS or DRED. In summary, the systematic review supports the safety and efficacy of remotely supervised exercise interventions for improving glycemic control, cardiorespiratory fitness, and QoL. The clinical trial findings further corroborate that such interventions can yield relevant psychosocial benefits, particularly in enhancing sleep quality and QoL. Nonetheless, future studies employing standardized protocols and improved methodological rigor are warranted to strengthen the scientific evidence and support the prescription of remotely supervised exercise as a therapeutic strategy for individuals with T2DM.