Effect of Exercise Interventions on Sarcopenia-Related Outcomes in Older Adults With Type 2 Diabetes: A Systematic Review and Meta-Analysis.
Amirhossein Jafari Harandi, Seyed Morteza Tayebi, Bakhtyar Tartibian et al.
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In 30 seconds
This systematic review and meta-analysis assessed structured exercise versus nonexercise control in adults with type 2 diabetes whose mean age was at least 65 years. Across 11 randomised controlled trials involving approximately 740 participants, exercise significantly improved muscle strength and physical performance, while the effect on lean mass was small and nonsignificant. Glycemic outcomes also improved: HbA1c fell by 0.32 percentage points and HOMA-IR improved by 0.51 units; fasting plasma glucose changes were small and nonsignificant. Adverse events were rare, with no serious exercise-related complications reported.
Key findings
- Muscle strength improved with exercise (nine trials; g = 0.67, 95% CI 0.46-0.88; I 2 = 11.7%).
- Physical performance improved (nine trials; g = 0.74, 95% CI 0.44-1.03; I 2 = 64.4%).
- Lean mass showed a small, nonsignificant effect (six trials; g = 0.14, 95% CI -0.09 to 0.37; I 2 = 0%).
- HbA1c decreased by 0.32 percentage points; HOMA-IR improved by 0.51 units, while FPG changes were small and nonsignificant.
Why it matters
Sarcopenia-related impairments and metabolic abnormalities can coexist in older adults with type 2 diabetes. These pooled trial findings suggest exercise may improve strength and physical function even when measurable lean-mass gains are limited, alongside improvements in some glycemic outcomes. The results help frame exercise as relevant to both functional and metabolic outcomes, while the evidence remains based on a modest number of trials.
What to keep in mind
The meta-analysis included 11 trials, with fewer studies contributing to some outcomes; physical-performance results showed substantial heterogeneity (I 2 = 64.4%).