The effect of exercise characteristics on HbA1c and other cardiovascular risk factors in adults with type 2 diabetes: a systematic review and meta-analysis of randomised controlled trials
Authors' conclusion
All types of exercise significantly improved HbA1c, with combined training producing the largest reduction. Moreover, each modality provides distinct advantages for other cardiovascular risk factors, with combined training offering the broadest benefits and HIIT serving as a time-efficient alternative.
Study context
- Population
- Adults with T2D; RCTs of exercise reporting HbA1c and CV risk factors, 9 databases searched to January 2025
- Participants
- 7,195 adults100 RCTs
- Comparison
- Exercise types vs control
- Combined trainingn = 38
- High-intensity interval training (HIIT)n = 13
- Continuous aerobic training (CAT)n = 57
- Resistance trainingn = 38
- Outcome
- HbA1c
Methodological detailsrandom-effects models, subgroup analyses
- Random-effects models
- Subgroup analyses
Pooled result
As reported in the abstract
HbA1c change
Combined training
- 0.74%
CI - 0.91; - 0.57
HIIT
- 0.71%
CI - 1.07; - 0.35
CAT
- .62%
CI - 0.84; - 0.41
Resistance training
- 0.36%
CI - 0.51; - 0.20
Further pooled results
HbA1c by subgroup: supervision and weekly volume
- Supervised interventions and weekly volume of 150-210 min consistently most effective
VO2peak
- Improved with CAT, combined training and HIIT
- + 2.77 to + 4.19 ml/kg/min
Muscle strength
- Improved with resistance and combined training (SMD)
- + 0.44 to + 0.66
FPG, LDL-C and systolic BP
- FPG reduced by all modalities
- - 0.60 to - 1.13 mmol/L
- LDL-C reduced by all modalities
- - 0.18 to - 0.31 mmol/L
- Systolic BP reduced by all modalities
- - 1.24 to - 4.15 mmHg
Body fat
- Improved only after CAT, combined training and HIIT (SMD)
- - 0.36 to - 0.59
Original publication
The effect of exercise characteristics on HbA1c and other cardiovascular risk factors in adults with type 2 diabetes: a systematic review and meta-analysis of randomised controlled trials. Cardiovasc Diabetol. Published 28 December 2025. doi:10.
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