Table 3

Effect of lifestyle and drug interventions on glucose levels

Type of studyGlucose (mmol/L)HbA1c (%)Reference
Lifestyle interventions
Weight loss
 Any interventionMeta-analysis −0.32 (−0.43 to −0.22) −0.40 (−0.52 to −0.28) 48
 Lifestyle weight loss, OW+T2DMMeta-analysis,<5% WLNR−0.2 (−0.6 to 0.2) 11
Meta-analysis, ≥5% WLNR −0.6 (−0.7 to −0.6) 11
 Intermittent versus continuous fastingMeta-analysis−0.03 (−0.11 to 0.06)−0.02 (−0.10 to 0.06) 12
 Any weight loss drugMeta-analysis−0.22 (−0.24 to 0.20)NR 13
Smoking cessation
Prospective studyNR0.03 17
Prospective study0.043NR 16
Intervention study −0.799* −0.2* 19
Intervention study0.122*NR 15
Diet
 Low carbohydrateMeta-analysis, T2DMNR −0.28 (−0.53 to −0.02) 68
 Low-glycaemic dietMeta-analysis0.12 (−0.02 to 0.25)NR 32
Meta-analysis0.027 (−0.071 to 0.125)−0.09 (−0.52 to 0.33) 53
Meta-analysis, T2DMNR −0.5 (−0.9 to −0.1) 69
 Mediterranean dietMeta-analysis −0.216 (−0.324 to −0.108) NR 39
 DASH dietMeta-analysis−0.19 (−0.39 to 0.17)NR 42
 High-intensity diet counsellingMeta-analysis −0.12 (−0.18 to −0.05) NR 44
Exercise
 Any exercise trainingMeta-analysis−0.07 (−0.13 to 0.004) −0.28 (−0.42 to −0.14) 62
 Aerobic, fitness or progressive resistance trainingMeta-analysis, T2DM−0.45 (−1.09 to 0.18) −0.62 (−0.91 to −0.33) 61
 Aerobic exerciseMeta-analysis, OW−0.063 (−0.190 to 0.064)NR 64
 Structured aerobicMeta-analysis, T2DMNR −0.73 (−1.06 to −0.40) 71
 Structured resistanceMeta-analysis, T2DMNR −0.57 (−1.14 to −0.01) 71
 Structured aerobic+resistanceMeta-analysis, T2DMNR −0.51 (−0.79 to −0.23) 71
 Exercise adviceMeta-analysis, T2DMNR−0.16 (−0.50 to 0.18) 71
Antidiabetic drugs
 MetforminReviewNR−1 to −2 99
 SulfonylureasReviewNR−1 to −2 99
 ThiazolidinedionesReviewNR−0.5 to −1.4 99
 SGLT2 inhibitorsReview−1.04 (−1.34 to −0.73)−0.74 (−0.88 to −0.59) 100
 Dipeptidyl peptidase 4 inhibitorsReviewNR−0.5 to −0.8 99
 GLP-1 agonistsReviewNR−0.5 to −1.5 99
 InsulinReviewNR−1 to −2.5 99
  • Results are expressed as value and (95% CI) whenever available. Lifestyle interventions with significant effects are indicated in bold font. *relative to people who continued smoking.

  • DASH, Dietary Approach to Stop Hypertension; GLP-1, glucagon-like peptide-1; NR, not reported; OW, overweight or obese subjects; SGLT2, sodium-glucose co-transporter 2; T2DM, type 2 diabetes mellitus; WL, weight loss.