Effectiveness of physical activity in managing co-morbid depression in adults with type 2 diabetes mellitus: A systematic review and meta-analysis

Physical activity may be effective in alleviating depressive symptoms and improving glycaemic control; however, evidence to guide practice is limited. The current review was conducted to assess the effects of physical activity on depression and glycaemic control in people with type 2 diabetes mellitus. Randomized controlled clinical trials, from the earliest record to October 2021, which recruited adults with the diagnosis of type 2 diabetes mellitus and compared physical activity with no interventions or usual care for the management of depression were included. The outcomes were change in depression severity and glycaemic control. In 17 trials, including 1362 participants, physical activity was effective in reducing the severity of depressive symptoms (SMD = −057; 95%CI = −0.80, −0.34). However, physical activity did not have a significant effect in improving markers of glycaemic control (SMD = −0.18; 95%CI = −0.46, 0.10). There was substantial heterogeneity in the included studies. Furthermore, risk of bias assessment showed that most of the included studies were of low quality. Physical activity can effectively reduce the severity of depressive symptoms, nonetheless, it appears that physical activity is not significantly effective in improving glycaemic control in adults who have both type 2 diabetes mellitus and depressive symptoms. The latter finding is surprising, however, given the limited evidence on which this is based, future research on the effectiveness of physical activity for depression in this population should include high quality trials with glycaemic control as an outcome. •Physical activity can be used to treat depression in adults with type 2 diabetes•Physical activity can be used alone, or it can be combined with other interventions.•Physical activity is suitable in both high- and low-income countries.•Both aerobic and resistance exercise can effectively treat depression.•Physical activity might have limited effects in achieving glycaemic control in people with both diabetes and depression.