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  • 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

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Systematic review
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
  1. Sameer Badri Al-Mhanna1,2,
  2. Barry A Franklin3,4,
  3. John M Jakicic5,
  4. Emmanuel Stamatakis6,7,
  5. Linda S Pescatello8,
  6. Deborah Riebe9,
  7. Walter R Thompson10,
  8. James Skinner11,
  9. Sheri R Colberg12,
  10. Nouf H Alkhamees13,
  11. Bodor Bin Sheeha13,
  12. Mehmet Gülü14,
  13. Abdullah F Alghannam15,
  14. Alexios Batrakoulis16,17
  1. 1 Center for Global Health Research, Saveetha Institute of Medical and Technical Sciences (Deemed to be University), Chennai, Tamil Nadu, India
  2. 2 Department of Higher Studies, Al Qasim Green University, Al Qasim, Iraq
  3. 3 Preventive Cardiology and Cardiac Rehabilitation, Corewell Health Beaumont Hospital, Royal Oak, Michigan, USA
  4. 4 Internal Medicine, Oakland University William Beaumont School of Medicine, Rochester, Michigan, USA
  5. 5 Department of Internal Medicine, The University of Kansas Medical Center, Kansas City, Kansas, USA
  6. 6 Mackenzie Wearables Research Hub, Charles Perkins Centre, The University of Sydney, Syndey, New South Wales, Australia
  7. 7 Faculty of Medicine and Health, School of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
  8. 8 Department of Kinesiology, University of Connecticut, Storrs, Connecticut, USA
  9. 9 College of Health Sciences, University of Rhode Island, Kingston, Rhode Island, USA
  10. 10 8College of Education and Human Development, Georgia State University, Atlanta, Georgia, USA
  11. 11 Department of Kinesiology, Indiana University Bloomington, Bloomington, Indiana, USA
  12. 12 Human Movement Sciences Department, Old Dominion University, Norfolk, Virginia, USA
  13. 13 Department of Rehabilitation, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
  14. 14 Department of Sports Management, Kirikkale University, Kirikkale, Turkey
  15. 15 Lifestyle and Health Research Center, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
  16. 16 Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
  17. 17 Department of Physical Education and Sport Science, Democritus University of Thrace, Komotini, Greece
  1. Correspondence to Dr Alexios Batrakoulis; abatrakoulis{at}uth.gr

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.

  • Exercise
  • Body composition
  • Glucose metabolism
  • Lipids
  • Physical activity

Data availability statement

Data are available upon reasonable request. Data are available on reasonable request by contacting the corresponding author.

https://doi.org/10.1136/bjsports-2024-108947

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    Data availability statement

    Data are available upon reasonable request. Data are available on reasonable request by contacting the corresponding author.

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    Footnotes

    • X @na, @M_Stamatakis, @AFAlghannam, @alexbatrakoulis

    • Contributors SA-M and AB conceived and designed the study. SA-M, NHA, BBS, AFA and AB selected the articles, extracted the data and assessed the risk of bias. SA-M analysed the data. BAF, JMJ, ES, DR, WRT, JS and MG accessed and verified the data. SA-M and AB wrote the first draft of the manuscript. BAF, JMJ, ES, DR, WRT, JS and MG interpreted the data and contributed to the writing and revising of the final version of the manuscript. All authors agreed with the results and conclusions of this article. AB is the guarantor.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.