Originally published by 2 Minute Medicine® (view original article). Reused on AccessMedicine with permission.

1. In this systematic review and meta-analysis, resistance training in patients with type 2 diabetes mellitus (T2DM) led to significant improvements in biochemical and clinical markers of disease, including fasting blood glucose, blood pressure, and fat mass.

2. In addition, the effect of high-intensity resistance training was superior to medium-low intensity training for improving several biochemical and clinical markers in patients with T2DM.

Evidence Rating Level: 1 (Excellent)

It has been well established that exercise plays an important non-pharmacological role in the treatment regimen of patients with type 2 diabetes (T2DM). Although resistance training plays a crucial role, previous studies have not defined the ideal training intensity that confers this benefit. As a result, the objective of the present systematic review and meta-analysis was to understand how exercise intensity may influence clinical and biochemical markers in T2DM.

Of 19,812 identified records, 40 (n=1,491 participants) studies were included from various databases from database inception to April 2022. Randomized controlled trials were included if patients were ≥17 years old, had T2DM, compared resistance training to either no exercise or only stretching, and evaluated biochemical and clinical markers of T2DM. Studies were excluded if the intervention period was <4 weeks and if patients did not have T2DM. The review was performed using PRISMA guidelines. The risk of bias was assessed using the Risk of Bias 2 tool (RoB2). Statistical analysis was performed using fixed or random effects models. The primary outcome was the effect of resistance training on clinical and biochemical markers in T2DM.

The results demonstrated that resistance training significantly lowered biochemical markers (e.g., HBA1c and fasting blood glucose) and clinical markers of T2DM, such as systolic blood pressure and fat mass. In addition, the effect of a high-intensity resistance training intervention was superior to a medium-low intensity for a number of biochemical and clinical markers. Despite these results, the review was limited by the heterogeneity of the included studies which may have influenced the magnitude of the effect sizes. Nonetheless, the present study added significant evidence to suggest that high-intensity resistance training should play a greater role in the treatment plan of patients with T2DM.

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