BACKGROUND: Type 2 diabetes mellitus (T2DM) is prevalent among overweight or obese women. Due to the chronic nature of diabetes, individuals with this condition often experience psychological complications, such as anxiety and depression. This study aimed to investigate the effects of Pilates exercises on anthropometric indices, anxiety, and depression in women with diabetes attending diabetes clinics in Zahedan, Iran. METHODS: This two-group quasi-experimental study with pre-test and post-test assessments included 60 female patients diagnosed with T2DM who attended diabetes clinics in Zahedan within March 2021 and July 2022. The participants were selected using convenience sampling and then randomly assigned to either the Pilates exercise group or the control group using a random allocation method with permutation blocks. Initially, anthropometric indices, including body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR), were measured, and the Hospital Anxiety and Depression Scale was completed by both groups. The intervention group participated in Pilates exercises three times a week for 8 weeks, with each session lasting 60 minutes and supervised by a Pilates exercise expert. The control group received routine care at the diabetes clinic, including diet counseling and medication adjustments. After 8 weeks, the data were collected again and statistically analyzed using SPSS 22 software. The significance level was set at p < 0.05. RESULTS: Significant differences were observed in anxiety scores before and after the intervention (13.33 +/- 2.6 and 3.2 +/- 5.41, respectively; p = 0.001), depression scores (11.9 +/- 2.61 and 2.56 +/- 1.85, respectively; p = 0.001), and anthropometric indices (p < 0.05). Waist circumference (96.20 +/- 9.86 and 92.25 +/- 8.56, respectively; p = 0.001), BMI (27.75 +/- 1.99 and 26.67 +/- 2.03, respectively; p = 0.001), and WHR (0.97 +/- 0.06 and 0.93 +/- 0.17, respectively; p = 0.001) all showed significant improvements. CONCLUSIONS: Exercise is a crucial non-pharmacological intervention in the management of diabetes. The results of this study demonstrate that Pilates exercises can effectively reduce anxiety and depression while improving anthropometric indices in women with T2DM. Therefore, it is recommended to incorporate Pilates exercises as amethod to reduce anxiety and depression and enhance anthropometric indicators in this population.

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