Community-based exercise in patients with prediabetes and type 2 diabetes: A Systematic Review, Meta-Regression and Meta-Analysis

Abstract Background This study aims to evaluate the efficacy of community-based exercise interventions among individuals with prediabetes and type 2 diabetes mellitus. Method This review followed Cochrane and PRISMA-2020 guidelines. A comprehensive literature search revealed 23 studies on the efficacy of community-based physical activity, of which 14 were trials. A random-effects model was employed to evaluate the effectiveness of the intervention. Effect sizes were calculated using Hedge's g standardized mean difference (SMD) based on the percentage change index. This study was registered with PROSPERO (CRD420251111667). Results Pooled analyses demonstrated no statistically significant overall effects on mean body mass index, waist circumference, blood pressure, glycaemic parameters, or lipid concentrations. Substantial intertrial heterogeneity was evident across multiple outcomes. However, evidence indicated a possible dose–response association, wherein interventions of greater intensity or frequency of contact were generally associated with more pronounced improvements. Conclusions Further rigorously designed RCTs with extended follow-up periods are necessary to confirm the effectiveness of community-based interventions in lowering cardiometabolic events in populations at risk for diabetes or prediabetes.