This research review aimed to evaluate the effect of practicing Tai Chi on glucose and lipid metabolism in middle-aged and elderly diabetic patients. Furthermore, it aimed to provide a theoretical basis for the practice of Tai Chi as a way to improve glucose and lipid metabolism in middle-aged and elderly diabetic patients. Therefore, we searched for randomized controlled trials on the practice of Tai Chi in middle-aged and elderly diabetic patients in Chinese- and English-language electronic databases, such as Web of Science, PubMed, the Cochrane Library, Embase, Google Scholar, CNKI, Wanfang Database, and Weipu. We collected articles published no later than August 1, 2020. The methodological quality of the included studies was evaluated according to the standards of the Cochrane Collaboration System Evaluation Manual (version 5.1.0). Finally, 14 articles were included, showing an average Physiotherapy Evidence Database scale score of 6.57. The articles were meta-analyzed using Stata 14.0 software, showing that practicing Tai Chi improved middle-aged and elderly diabetic patients' fasting blood glucose (WMD -0.60, 95% CI (-1.08 to -0.12), p = 0.015), glycosylated hemoglobin (WMD -0.87, 95% CI (-1.60 to -0.14), p = 0.019), total cholesterol (WMD -0.48, 95% CI (-0.83 to -0.14), p = 0.006), triglycerides (WMD -0.21, 95% CI (-0.37 to -0.04), p = 0.014), and low-density lipoprotein cholesterol level significantly (WMD -0.32, 95% CI (-0.63 to -0.00), p = 0.050). Conversely, patients' high-density lipoprotein cholesterol levels (WMD 0.09, 95% CI (-0.01 to 0.17), p = 0.136) showed no obvious improvement. In conclusion, practicing Tai Chi in sessions lasting longer than 50 minutes (at least three times per week, for at least 12 weeks) can effectively improve glucose and lipid metabolism in middle-aged and elderly diabetic patients. However, several other factors affect glucose and lipid metabolism; therefore, further high-quality research is needed.

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