Shear wave elastography for early assessment of exercise intervention effects in type 2 diabetes: a methodological study

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This study aims to investigate whether shear wave elastography (SWE) can detect early changes in muscle function following different exercise interventions in type 2 diabetes (T2DM), and to explore its value as a monitoring tool for exercise efficacy. This exploratory methodological study enrolled 72 patients with T2DM, of whom 66 completed the 12-week intervention and were included in the per-protocol analysis, randomly assigned to high intensity interval exercise (HIIE, n = 32, 3 times/week) or moderate intensity aerobic exercise (MIAE, n = 34, 5 times/week) for 12 weeks. Glycated hemoglobin (HbA1c), the medial head of the right gastrocnemius thickness, and shear wave velocity (SWV) were measured at baseline, week 1, week 8, and week 12. Temporal patterns of changes were analyzed using independent t-tests, paired t-tests, and repeated measures analysis of variance (ANOVA). No significant baseline differences were observed between groups (p > 0.05). SWV increased significantly as early as week 1 in the HIIE group (p < 0.05) and at week 8 in the MIAE group (p < 0.05), preceding improvements in HbA1c and muscle thickness in both groups (week 8 and week 12, respectively). Significant group-by-time interactions were observed for all outcomes (all p < 0.05, η2p > 0.06). Here we show that SWE detects exercise-induced muscle changes earlier than traditional indicators in T2DM, suggesting its potential for early monitoring of exercise responses. Further functional validation is warranted. ClinicalTrials.gov NCT07836088, registered on 14 September 2026 (Retrospectively registered).