AIMS: To compare the magnitude of the benefit of different exercise modalities on glycemic control, including aerobic training (AT), resistance training (RT), combined training (CT), high-intensity interval training (HIIT) and physical activity advice. METHODS: A network meta-analysis was conducted. Seven databases were searched from inception to May 2024. We included randomized clinical trials of at least 12 weeks' duration evaluating different types of physical exercise and physical activity advice to reduce HbA1c in people with type 2 diabetes. RESULTS: 158 studies (17,059 participants) were included. Compared with the control group, all types of exercise were associated with lower HbA1c: HIIT (-0.61% (95% CrI -0.84 to -0.37)), CT (-0.58% (95% CrI -0.73 to -0.42), AT (-0.58% (95% CrI -0.70 to -0.45)), RT (-0.40% (95% CrI -0.59 to -0.21)) and physical activity advice (-0.35% (95% CrI -0.53 to -0.16)). HIIT was the most effective treatment for HbA1c reduction (SUCRA 82%), followed by CT (SUCRA 77%), AT (SUCRA 76%), RT (SUCRA 37%) and physical activity advice (SUCRA 29%). CONCLUSIONS: HIIT was associated with the greatest reduction in HbA1c. Physical activity advice, which is easy to implement, accessible and unsupervised, should also be offered to people with type 2 diabetes to improve glycemic control.
With permission from Excerpta Medica Inc.

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