Impact of resistance training on cardiometabolic health-related indices in patients with type 2 diabetes and overweight/obesity: a systematic review and meta-analysis of randomised controlled trials

Abstract

Objective: To evaluate the effects of resistance training on cardiometabolic health-related outcomes in patients with type 2 diabetes mellitus (T2DM) and overweight/obesity.

Design: Systematic review and meta-analysis of randomised controlled trials (RCTs).

Data sources: PubMed, Web of Science, Scopus, Science Direct, Cochrane Library and Google Scholar databases were searched from inception up to May 2024. The search strategy included the following keywords: diabetes, resistance exercise and strength training.

Eligibility criteria for selecting studies: RCTs published in English comparing resistance training alone with non-exercising standard treatment. Participants were adults diagnosed with T2DM and concurrent overweight/obesity (body mass index (BMI) ≥25 kg/m²).

Results: A total of 18 RCTs qualified involving 1180 patients (48.6/51.4 female/male ratio; 63.3±7.0 years; 29.3±4.3 kg/m²). Waist circumference (standardised mean differences (SMD) -0.85 cm, 95% CI -1.66 to -0.04), waist-to-hip ratio (SMD -0.72, 95% CI -1.30 to -0.15), high-density lipoprotein cholesterol (SMD +0.40 mg/dL, 95% CI 0.07 to -0.72), triglycerides (SMD -0.54 mg/dL, 95% CI -1.06 to -0.02), fasting blood glucose (SMD -0.65 mmol/L, 95% CI -1.19 to -0.12), fasting insulin (SMD -0.74 uIU/mL, 95% CI -1.12 to -0.36) and glycated haemoglobin (SMD -0.32%, 95% CI -0.63 to -0.01) improved compared with standard treatment. The risk of bias was low to unclear, and the quality of evidence was very low to moderate.

Conclusions: Resistance training as a standalone exercise intervention in the management and treatment of T2DM with concurrent overweight/obesity is associated with many cardiometabolic benefits when compared with standard treatment without exercise.

Prospero registration number: CRD42022355612.

Keywords: Body composition; Exercise; Glucose metabolism; Lipids; Physical activity.