Key result
HIIT reduces HbA1c by ~1% versus control, outperforming other exercises in older T2DM adults.
Why the study?
Age-related functional decline and cardiometabolic comorbidities in older adults with T2DM may alter glycemic responses to exercise, yet exercise modality and dose recommendations are largely based on general adult populations.
Do different exercise modalities and doses improve glycemic control in older adults with type 2 diabetes mellitus?
Meta-Analysis
Do different exercise modalities and doses improve glycemic control in older adults with type 2 diabetes mellitus?
Mean Difference: -1.02 (95% CI -1.48–-0.59)
All exercise modalities, particularly high-intensity interval training, provide clinically meaningful HbA1c reductions in older adults with type 2 diabetes, with optimal benefits observed at approximately 630 METs-min/week.
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Supports prioritizing HIIT for glycemic control in older T2DM adults; extends general-population evidence with modality- and dose-specific data.
Introduction and Objective: Age-related functional decline and cardiometabolic comorbidities in older adults with type 2 diabetes mellitus (T2DM) may alter glycemic responses to exercise, yet recommendations on exercise modality and dose are largely based on general adult populations. We compared the effects of different exercise modalities and evaluated dose-response relationships with glycemic control in older adults with T2DM. Methods: We systematically searched PubMed, Embase, and the Cochrane Library for randomized controlled trials of exercise interventions in older adults with T2DM reporting glycated hemoglobin (HbA1c) outcomes. Pairwise, Bayesian network, and dose-response meta-analyses were conducted using random-effects models. Results: We included 46 randomized controlled trials. In the network meta-analysis, high-intensity interval training (HIIT) produced the largest HbA1c reduction versus minimal-intervention control (MD = −1.02%; 95% CrI −1.48, −0.59). All modalities reduced HbA1c, with more modest reductions for combined exercise (CE) (MD = −0.60%; 95% CrI −0.94, −0.26), mind-body exercise (MBE) (MD = −0.54%; 95% CrI −0.88, −0.20), continuous aerobic exercise (CAE) (MD = −0.44%; 95% CrI −0.66, −0.23), and resistance training (RT) (MD = −0.36%; 95% CrI −0.59, −0.15). Dose-response network meta-analyses identified a non-linear association, with maximal HbA1c reductions at approximately 630 METs-min/week and significant benefits between 390 and 840 METs-min/week. HIIT exhibited the steepest gradient, whereas CAE and MBE showed modality-specific dose-response patterns with intermediate optimal ranges. Conclusion: All exercise modalities were associated with clinically meaningful HbA1c reductions compared with control. HIIT showed the most pronounced estimated benefit, followed by CE and MBE, whereas CAE and RT produced smaller reductions, with meaningful improvements at moderate weekly exercise volumes. Disclosure Y. Park: None. Y. Shin: None. Y. Yuan: None. J.Y. Jeon: None. D. Lee: None. Funding National Research Foundation of Korea (NRF- 20241A5C3A02043449)
PARK et al. (2026) conducted a meta-analysis in Type 2 diabetes mellitus. Exercise interventions (e.g., high-intensity interval training) vs. Minimal-intervention control was evaluated on Glycated hemoglobin (HbA1c) (MD -1.02%, 95% CI -1.48 to -0.59). High-intensity interval training produced the largest HbA1c reduction versus minimal-intervention control (MD -1.02%; 95% CrI -1.48 to -0.59) among exercise modalities in older adults with T2DM.
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