OBJECTIVE: To explore the effects and dose-response relationship of Tai Chi for type 2 diabetes mellitus (T2DM) and to evaluate the methodological quality of the included trials and evidence quality of the outcomes. METHODS: Nine major English and Chinese databases were searched for randomized controlled trials of Tai Chi for T2DM from inception to December 2021. The effects and dose-response relationships were assessed with a meta-analysis and meta-regression using Stata.16. The methodological quality of the included studies was assessed using the risk of bias tool. The evidence quality of the outcomes was assessed using the GRADE tool. RESULTS: A total of 24 studies with 1314 patients were included. Compared with the usual care, Tai Chi improved HbA1c (MD -0.80%, 95% CI (-1.05 to -0.54), p < 0.001, I2 18.29%, very low-quality evidence), FBG (SMD -0.58, 95% CI (-0.86 to -0.31), p < 0.001, I2 53.2%, low-quality evidence), fasting insulin (FIN), diastolic blood pressure, BMI, and the outcomes of quality of life (QoL) in patients with T2DM. However, when Tai Chi was compared with other exercise, there was no between-group difference in the HbA1c, FBG, TC, TG, HDL, LDL, BMI, and waist circumference (WC). Furthermore, the findings showed that an increase at every 18 weeks in length or an 823-h increase in the total time of Tai Chi intervention resulted in approximately a one unit reduction in the SMD of FBG. CONCLUSIONS: Compared with usual care, Tai Chi may improve HbA1c (with clinical significance), FBG, FIN, BMI, diastolic blood pressure, and outcomes of QoL in T2DM patients. The effects of Tai Chi were similar to those of other exercises on the HbA1c, FBG, TC, TG, HDL, LDL, BMI, and WC. Given the overall poor methodological quality and evidence quality, these findings should be treated cautiously.

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