Clinical Report: Evaluating Exercise Types and Intensities for Glycemic Management

Overview

This systematic review and network meta-analysis evaluated the effects of various exercise modalities on glycemic control in older adults with type 2 diabetes mellitus (T2DM). The findings indicate reductions in glycated hemoglobin (HbA1c) and fasting blood glucose (FBG) with combined aerobic and resistance exercise (CE).

Background

The prevalence of type 2 diabetes mellitus (T2DM) is increasing globally, particularly among older adults. Poor glycemic control in this population is associated with heightened risks of serious health complications, including cardiovascular disease and cognitive decline. Exercise is a recommended intervention for managing T2DM, yet the optimal types and intensities of exercise for this demographic remain inadequately defined.

Data Highlights

Key Findings

• Thirty-four RCTs with 2461 participants were included in the analysis.
• Combined aerobic and resistance exercise (CE) showed the greatest reduction in HbA1c (MD = -1.05%).
• CE also resulted in significant reductions in fasting blood glucose (FBG) (MD = -1.44 mmol/L).
• Improvements in HbA1c and FBG began at approximately 520 and 500 MET-min/week, respectively.
• Only CE showed a significant reduction in 2-hour postprandial glucose (2hPG) compared to the control group.

Clinical Implications

The findings indicate that combined aerobic and resistance exercise may improve glycemic control in older adults with T2DM.

Conclusion

Exercise interventions, particularly combined aerobic and resistance exercise, are associated with improvements in glycemic control in older adults with T2DM.

Related Resources & Content

1. Wu et al., Frontiers in Endocrinology, 2025 -- Evaluating Exercise Types and Intensities for Glycemic Management in Older Adults with Type 2 Diabetes: A Systematic Review and Network Meta-Analysis
2. The Journal of Clinical Endocrinology & Metabolism — Customizing Exercise Recommendations for Optimal Glycemic Control in Diabetes Management
3. BMC Endocrine Disorders — Effects of digital and remote exercise interventions on HbA1c in type 2 diabetes: a systematic review and network meta-analysis
4. Frontiers in Endocrinology — Effects of high-intensity interval training and moderate-intensity continuous training on type 2 diabetes mellitus: a meta-analysis and systematic review
5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes—2026
6. Effects of exercise training and physical activity advice on HbA1c in people with type 2 diabetes: A network meta-analysis of randomized controlled trials