Effects of Different Modes of Exercise Training on Glucose Control and Risk Factors for Complications in Type 2 Diabetic Patients
Open accessAbstract
OBJECTIVE—We sought to meta-analyze the effects of different modes of exercise training on measures of glucose control and other risk factors for complications of diabetes. RESEARCH DESIGN AND METHODS—The 27 qualifying studies were controlled trials providing, for each measure, 4–18 estimates for the effect of aerobic training, 2–7 for resistance training, and 1–5 for combined training, with 1,003 type 2 diabetic patients (age 55 ± 7 years [mean ± between-study SD]) over 5–104 weeks. The meta-analytic mixed model included main-effect covariates to control for between-study differences in disease severity, sex, total training time, training intensity, and dietary cointervention (13 studies). To interpret magnitudes, effects were standardized after meta-analysis using composite baseline between-subject SD. RESULTS—Differences among the effects of aerobic, resistance, and combined training on HbA1c (A1C) were trivial; for training lasting ≥12 weeks, the overall effect was a small beneficial reduction (A1C 0.8 ± 0.3% [mean ± 90% confidence limit]). There were generally small to moderate benefits for other measures of glucose control. For other risk factors, there were either small benefits or effects were trivial or unclear, although combined training was generally superior to aerobic and resistance training. Effects of covariates were generally trivial or unclear, but there were small additional benefits of exercise on glucose control with increased disease severity. CONCLUSIONS—All forms of exercise training produce small benefits in the main measure of glucose control: A1C. The effects are similar to those of dietary, drug, and insulin treatments. The clinical importance of combining these treatments needs further research.
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Exercise reduces cardiovascular risk factors, contributes to weight loss, and improves sense of well-being in people with diabetes.
“In addition to improving BG control, exercise has been shown to reduce CV risk factors, contribute to weight loss, and improve sense of well-being.943,946–948”
From American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. (2022) · cites this paper as [948]
The Effects of exercise section (page not provided) reports small or moderate blood-pressure benefits from aerobic and combined exercise, and mostly trivial or small benefits for anthropometric measures, including body mass. It does not report an improvement in sense of well-being; its findings on blood lipids are mostly trivial or unclear. Thus the citation supports parts of the claim, but not all of it. (LLM, conf=0.88)
Experimental — accuracy not yet measuredHigher amounts of aerobic exercise are linked to markedly lower cardiovascular and all-cause mortality in type 1 and type 2 diabetes.
“Moderate to high volumes of aerobic activity are associated with substantially lower CV and overall mortality risks in both T1D and T2D.948,949”
From American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. (2022) · cites this paper as [948]
The 'Moderating effects of study characteristics' section discusses an estimated cardiovascular-disease risk reduction inferred from A1C changes in type 2 diabetes, not observed cardiovascular or all-cause mortality. It says an assessment of morbidity and mortality would require studies the authors did not have. Searches for mortality, type 1 diabetes, and exercise volume found no passage establishing the claimed association. (LLM, conf=0.77)
Experimental — accuracy not yet measuredAerobic and resistance exercise improve glycemic control in patients with type 2 diabetes.
“Aerobic and resistance exercise have been well studied and are known to improve glycemic control in patients with T2DM.”
From The Impact of Physical Activity in Patients With Type 2 Diabetes (2025) · cites this paper as [29]
Regular aerobic exercise in type 2 diabetes improves A1c, blood pressure, triglyceride levels, and decreases insulin resistance.
“Regular aerobic exercise in patients with T2DM has been shown to improve A1c, blood pressure, triglyceride levels, and decrease insulin resistance.”
From The Impact of Physical Activity in Patients With Type 2 Diabetes (2025) · cites this paper as [29]
Systematic reviews and meta-analyses show fewer daily hyperglycemia episodes and A1c reductions of 0.3% to 0.7% with aerobic training.
“Systematic reviews and meta-analyses have shown fewer daily episodes of hyperglycemia and a reduction in A1c by .3-.7% with aerobic training.”
From The Impact of Physical Activity in Patients With Type 2 Diabetes (2025) · cites this paper as [29]
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- Authors
- Snowling, N. J., & Hopkins, W. G.
- Affiliations
- Auckland University of Technology (NZ)
- ORCID
- Hopkins, Will G.
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2006-11-01
- Volume
- 29
- Issue
- 11
- Pages
- 2518-2527
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2170920749
- Cited by
- 813
- References
- 78
- Citations by year
- 2026: 16 · 2025: 29 · 2024: 47 · 2023: 40 · 2022: 37 · 2021: 49 · 2020: 45 · 2019: 40 · 2018: 31 · 2017: 54 · 2016: 44 · 2015: 40 · 2014: 64 · 2013: 50 · 2012: 65
- FWCI
- 3.03
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Victoria University Research Repository (Victoria University) (submittedVersion)
- 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 Management and Research
- Keywords
- type 2 diabetes, exercise training, aerobic exercise, resistance training, concurrent training, glycemic control, HbA1c, diabetes complications, disease severity
- MeSH terms
- Blood Glucose, Diabetes Mellitus, Type 2, Humans, Risk Factors, Exercise, Diabetes Complications
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