Exercise modalities and dosages on glycated haemoglobin and exerkines in type 2 diabetes: a systematic review with pairwise, network, and dose-response meta-analyses
Pooled result · HbA1c reduction: modality ranking and dose-responseResult — go to the resultMD −0.57 % 95% CrI −0.72 to −0.42Authors' conclusion
In adults with T2DM, exercise efficacy varies by modality and follows a dose-plateau pattern. The achievement of 600 MET-min/week produces a meaningful reduction in HbA1c levels, with diminishing returns being observed beyond approximately 1,000 MET-min/week. MBRT and HIIT are the most promising modalities, although the evidence concerning MBRT remains preliminary in nature. Modality-specific exerkine patterns were observed; specifically, HIIT ranked highest for adiponectin, whereas RT ranked highest for IL-6 and TNF-α. These findings inform evidence-based, personalised exercise prescription in T2DM patients.
Study context
- Population
- Adults with T2D; RCTs up to October 2025
- Participants
- 8,744 adults127 trials
- Comparison
- Eight exercise modalities and exercise doses vs control
- Outcome
- HbA1c
Methodological detailsBayesian evidence synthesis, pairwise meta-analysis, model-based dose-response meta-analysis
- Bayesian evidence synthesis
- Pairwise meta-analysis
- Model-based dose-response meta-analysis
Pooled result
As reported in the abstract
MD
−0.57 %
95% CrI −0.72 to −0.42
By group
Further pooled results
Exerkines (exploratory)
- High-intensity interval training (HIIT) associated with greater increases in adiponectin
- Resistance-based interventions trended towards greater reductions in IL-6 and TNF-α
- Pairwise vs control: no significant overall changes in adiponectin, brain-derived neurotrophic factor (BDNF), IL-6 or resistin
- Exploratory analyses
Original publication
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