Exercise remains an important component of cardiovascular risk management in people with type 2 diabetes mellitus (T2DM), but the vascular effects of resistance training (RT)-based interventions have been less clearly defined than those of aerobic training (AT). A systematic review and meta-analysis published in Frontiers in Endocrinology evaluated the effects of RT alone or RT combined with AT on vascular function in adults with T2DM.
The analysis followed PRISMA guidelines and searched PubMed, Embase, Web of Science, the Cochrane Library, Ovid, CNKI, Wanfang Data, VIP, and CBM through August 2025. Randomized controlled trials (RCTs) comparing RT alone or RT+AT with non-exercise controls in adults with T2DM were included. Random-effects meta-analyses were performed using Hedge’s g and 95% confidence intervals (CIs).
Findings
- RT-based interventions reduced arterial stiffness (Hedge’s g = −0.24; 95% CI, −0.39 to −0.09; p=0.0015) and improved endothelial function (Hedge’s g = 0.61; 95% CI, 0.32–0.89; p<0.0001).
- Subgroup analyses suggested that combined RT+AT interventions produced more consistent vascular improvements than RT alone, particularly in higher-intensity and longer-duration programs.
- Meta-regression analyses did not identify significant linear associations between intervention characteristics and vascular outcomes (p>0.05).
- No significant improvement was observed in wave reflection indices (Hedge’s g = −0.10; 95% CI, −0.45 to 0.25; p=0.58).
- Findings for peripheral hemodynamic outcomes remained inconclusive (Hedge’s g = 0.44; 95% CI, −0.00 to 0.88; p=0.05).
The findings suggest that RT-based interventions, particularly combined RT+AT programs, may improve vascular function in adults with T2DM, although conclusions regarding isolated RT remain cautious because pooled estimates reflected RT-based interventions overall.
