OBJECTIVE: To systematically synthesize and critically evaluate evidence on the effects of Tai Chi for patients with type 2 diabetes mellitus. DATA SOURCES: Seven electronic databases (Wan Fang, SinoMed, China National Knowledge Infrastructure, VIP, PubMed, Embase, and Cochrane Library) were systematically searched from their inception to March 2018. STUDY SELECTION: Randomized controlled trials investigating the effects of Tai Chi on individuals with type 2 diabetes mellitus were eligible. DATA EXTRACTION: Biomedical outcomes (fasting plasma glucose, glycosylated haemoglobin (HbA1c), fasting insulin, insulin resistance, body mass index, total cholesterol, blood pressure) as well as balance and quality of life-related outcomes were extracted independently by 2 reviewers. Stata 12.0 software was used to synthesize data if there was no or moderate heterogeneity across studies. Otherwise, narrative summaries were performed. DATA SYNTHESIS: A total of 23 studies (25 articles) involving 1,235 patients were included in this meta-analysis. Significant changes in Tai Chi-related effects were observed in lowering fasting plasma glucose (standardized mean difference; SMD -0.67; 95% confidence interval (95% CI) -0.87 to -0.47; p < 0.001), HbA1c (mean difference MD -0.88%; 95% CI -1.45% to -0.31%; p = 0.002) and insulin resistance (MD -0.41; 95% CI -0.78 to -0.04; p = 0.029). Beneficial effects of Tai Chi were also found in decreasing body mass index (MD -0.82 kg/m2; 95% CI -1.28 to -0.37 kg/m2; p < 0.001) and total cholesterol (SMD -0.59; 95% CI -0.90 to -0.27; p < 0.001). In addition, Tai Chi reduced blood pressure (systolic blood pressure (MD -10.03 mmHg; 95% CI -15.78 to -4.29 mmHg; p = 0.001), diastolic blood pressure (MD -4.85 mmHg; 95% CI -8.23 to -1.47 mmHg; p = 0.005)) and improved quality of life-related outcomes (physical function (MD 7.07; 95% CI 0.79 to 13.35; p = 0.027), bodily pain (MD 4.30; 95% CI 0.83 to 7.77; p = 0.015) and social function (MD 13.84; 95% CI 6.22 to 21.47; p < 0.001)). However, no impact was exerted on fasting insulin (SMD -0.32; 95% CI -0.71 to 0.07; p = 0.110) or balance (MD 2.71 s; 95% CI -3.29 to 8.71 s; p = 0.376). CONCLUSION: Tai Chi is effective in controlling biomedical outcomes and improving quality of life-related outcomes in individuals with type 2 diabetes mellitus, although no effects were observed on balance and fasting insulin. Further high-quality research is needed to elucidate the effects of different types of Tai Chi, the long-term effects of Tai Chi, the impact on respiratory function, and the association between Tai Chi and the risk of developing type 2 diabetes mellitus in healthy individuals.

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