Exercise and insulin resistance in type 2 diabetes mellitus: A systematic review and meta-analysis
Open accessAbstract
Background Insulin resistance is a determining factor in the pathophysiology of type 2 diabetes mellitus (T2DM). Exercise is known to improve insulin resistance, but a systematic review of the literature is lacking. Objective This systematic review and meta-analysis focused on identifying evidence for the effectiveness of a structured exercise intervention program for insulin resistance in T2DM. Methods We searched MEDLINE via PubMed, CINHAL, Scopus and Web of Science, and the Cochrane Central Register of Controlled Trials for reports of studies on fasting insulin, homeostatic model assessment for insulin resistance (Homa-IR), fasting blood sugar, glycated hemoglobin and body mass index in patients with T2DM and healthy controls that were published between 1990 and 2017. Data are reported as the standardized mean difference or mean difference with 95% confidence intervals (CIs). Results Among 2242 records retrieved, only 11 full-text articles were available for meta-analysis. Data for 846 participants were analyzed, 440 in the intervention group, and 406 in the control group. The mean difference for fasting insulin level was-1.64 (95% CI; -3.38 to 0.10), Homa-Ir 0.14 (-1.48 to 1.76), fasting blood sugar-5.12 (-7.78 to-2.45), hemoglobin A1c 0.63 (-0.82 to 2.08) and body mass index-0.36 (-1.51 to 0.79). Conclusion The evidence highlights the effectiveness of a structured exercise intervention program for insulin resistance in T2DM with a moderate level 2 of evidence.
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Clinical studies have found decreased fasting levels of insulin in healthy individuals who engage in supervised exercise interventions and in patients with established T2DM.
“Regarding exercise interventions, clinical studies have found decreased fasting levels of insulin not only in healthy individuals who engage in supervised exercise interventions [35], but also in patients with established T2DM at the other end of the spectrum [273].”
Multiple studies show hemoglobin A1c improvements of 0.5% to 0.7% with combined aerobic and resistance training.
“Multiple studies have shown significant improvements in hemoglobin A1c (0.5-0.7%) of patients with T2DM through a combination of aerobic and resistance training.”
From The Impact of Physical Activity in Patients With Type 2 Diabetes (2025) · cites this paper as [38]
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The Impact of Physical Activity in Patients With Type 2 Diabetes
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- Authors
- Sampath Kumar, A., Maiya, A. G., Shastry, B. A., Vaishali, K., Ravishankar, N., Hazari, A., Gundmi, S., & Jadhav, R.
- Affiliations
- Manipal Academy of Higher Education (IN)
- Kasturba Medical College Hospital (IN)
- Corresponding author
- Maiya, Arun G.
- ORCID
- Venue
- Annals of Physical and Rehabilitation Medicine
- Publisher
- Elsevier BV
- Published
- 2019-03
- Volume
- 62
- Issue
- 2
- Pages
- 98-103
- ISSN
- 1877-0657 (ISSN-L)
- OpenAlex
- W2904698845
- Cited by
- 469
- References
- 23
- Citations by year
- 2026: 44 · 2025: 89 · 2024: 81 · 2023: 115 · 2022: 78 · 2021: 46 · 2020: 11 · 2019: 4
- FWCI
- 2.00
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Annals of Physical and Rehabilitation Medicine (publishedVersion)
- PubMed (publishedVersion)
- University of Birmingham Research Portal (University of Birmingham) (submittedVersion, other-oa)
- Funders
- Manipal Academy of Higher Education
- World Diabetes Foundation
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- exercise intervention, insulin resistance, type 2 diabetes, fasting insulin, HOMA-IR, HbA1c, fasting blood glucose, body mass index, structured exercise program
- MeSH terms
- Adolescent, Adult, Blood Glucose, Diabetes Mellitus, Type 2, Exercise Therapy, Fasting, Female, Humans, Insulin Resistance, Male, Exercise, Treatment Outcome, Young Adult
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