Evidence mapPaperPMID 41457265Full record

SynthesisCardiovascular diabetology2025

The effect of exercise characteristics on HbA1c and other cardiovascular risk factors in adults with type 2 diabetes: a systematic review and meta-analysis of randomised controlled trials.

Matthijs Michielsen, Jan Yagiz, Matthijs Hanssens, Jomme Claes, Lieze Geuns, Tin Gojevic, Dominique Hansen, Guido Claessen, Marieke De Craemer, Véronique Cornelissen

Abstract readSystematic ReviewMeta-AnalysisReview
In one paragraph

Synthesis in Cardiovascular diabetology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 3 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Trial
  5. Observational
  6. Article
  7. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Matthijs MichielsenDepartment of Rehabilitation Sciences, KU Leuven, O&N 4 - Flex Offices, Herestraat 49 B 1501, 3000, Leuven, Belgium. matthijs.michielsen@kuleuven.be.ORCID http://orcid.org/0000-0001-9816-7359
Jan YagizDepartment of Rehabilitation Sciences, KU Leuven, O&N 4 - Flex Offices, Herestraat 49 B 1501, 3000, Leuven, Belgium.
Matthijs HanssensDepartment of Rehabilitation Sciences, KU Leuven, O&N 4 - Flex Offices, Herestraat 49 B 1501, 3000, Leuven, Belgium.
Jomme ClaesDepartment of Rehabilitation Sciences, KU Leuven, O&N 4 - Flex Offices, Herestraat 49 B 1501, 3000, Leuven, Belgium.
Lieze GeunsDepartment of Rehabilitation Sciences, KU Leuven, O&N 4 - Flex Offices, Herestraat 49 B 1501, 3000, Leuven, Belgium.
Tin GojevicFaculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium.
Dominique HansenFaculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium.
Guido ClaessenDepartment of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.
Marieke De CraemerDepartment of Rehabilitation Sciences, Ghent University, Gent, Belgium.
Véronique CornelissenDepartment of Rehabilitation Sciences, KU Leuven, O&N 4 - Flex Offices, Herestraat 49 B 1501, 3000, Leuven, Belgium.

Funding

Fonds Wetenschappelijk Onderzoek G095221NFonds Wetenschappelijk Onderzoek T004420N
6 · The paper itself

Abstract

backgroundExercise is a first-line therapy in adults with type 2 diabetes, yet its optimal characteristics remain unclear. Moreover, most meta-analyses focus on glycated haemoglobin (HbA1c), providing limited insight into the concomitant effects of these exercise programmes on the overall cardiovascular risk profile.

methodsA systematic review and meta-analysis was conducted. Nine electronic databases were searched from inception to January 2025 for randomised controlled trials evaluating the effects of exercise on HbA1c and concomitantly reported cardiovascular risk factors in adults with type 2 diabetes. Outcomes were pooled using random-effects models and analysed by exercise type. Subgroup analyses were performed to explore optimal exercise characteristics for improving HbA1c.

resultsOne hundred randomised controlled trials (7195 participants, 136 interventions) were included. All exercise types significantly improved HbA1c, with the largest reductions observed for combined training (− 0.74%, 95% CI [− 0.91; − 0.57], n = 38) and high-intensity interval training (HIIT) (− 0.71%, 95% CI [− 1.07; − 0.35], n = 13), followed by continuous aerobic training (CAT) (− .62%, 95% CI [− 0.84; − 0.41], n = 57) and resistance training (− 0.36%, 95% CI [− 0.51; − 0.20], n = 38). Supervised interventions and those prescribing a weekly volume of 150–210 min were consistently the most effective. Analyses of concomitantly reported cardiovascular risk factors showed improvements in VO2peak with CAT, combined training and HIIT (+ 2.77 to + 4.19 ml/kg/min) and in muscle strength with resistance and combined training (SMD: + 0.44 to + 0.66). All modalities reduced fasting plasma glucose (− 0.60 to − 1.13 mmol/L), LDL cholesterol (− 0.18 to − 0.31 mmol/L) and systolic blood pressure (− 1.24 to − 4.15 mmHg), while improvements in body fat were observed only after CAT, combined training and HIIT (SMD: − 0.36 to − 0.59).

conclusionsAll types of exercise significantly improved HbA1c, with combined training producing the largest reduction. Moreover, each modality provides distinct advantages for other cardiovascular risk factors, with combined training offering the broadest benefits and HIIT serving as a time-efficient alternative. Tailoring exercise programmes based on the patient’s individual risk profile, and adjusting exercise types accordingly, may help optimise outcomes.

trial registrationPROSPERO (CRD42025642391).

Indexed as

Blood GlucoseCardiovascular DiseasesDiabetes Mellitus, Type 2Exercise TherapyGlycated HemoglobinGlycemic ControlAdultAgedBiomarkersFemaleHeart Disease Risk FactorsHumansMaleMiddle AgedRandomized Controlled Trials as TopicRisk AssessmentBiomarkersBlood GlucoseGlycated Hemoglobinhemoglobin A1c protein, humanCardiovascular risk profileCombined trainingContinuous aerobic trainingExerciseHbA1cHigh-intensity interval trainingMeta-analysisResistance trainingType 2 diabetes

Identifiers

PMID41457265
PMCPMC12859889

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.