Combined aerobic and resistance exercise reduced HbA1c by 1.05% and fasting blood glucose by 1.44 mmol/L in older adults with type 2 diabetes, outperforming other exercise types including traditional Chinese sports, high-intensity interval training, continuous aerobic exercise, and resistance exercise alone.
- Combined aerobic and resistance exercise showed the greatest improvements in blood sugar control among older adults with type 2 diabetes
- Benefits began at approximately 520 MET-minutes per week for HbA1c and 500 MET-minutes per week for fasting blood glucose
- Analysis included 34 studies with 2,461 participants aged 60 and older
How this compares to prior research?
While exercise has long been recognized as essential for managing type 2 diabetes, previous research had not clearly established which specific exercise types and doses provide the greatest benefit for blood sugar control in older adults. Most prior studies examined exercise effects in mixed-age populations or focused on single exercise modalities. This network meta-analysis is among the first to systematically compare multiple exercise types and establish dose-response relationships specifically in adults aged 60 and older with type 2 diabetes.
Global diabetes prevalence trends, 1980–1989
Key findings
- Combined aerobic and resistance exercise reduced HbA1c by 1.05% and fasting blood glucose by 1.44 mmol/L compared to control groups
- All five exercise types tested (combined exercise, traditional Chinese sports, high-intensity interval training, continuous aerobic exercise, and resistance exercise) significantly reduced HbA1c compared to no exercise
- Significant blood sugar improvements began at approximately 520 MET-minutes per week for HbA1c and 500 MET-minutes per week for fasting blood glucose
What this means in practice
- Ask your doctor about starting a program that combines both aerobic exercise like walking and resistance training like weight lifting
- Aim for at least 520 MET-minutes per week, roughly equivalent to 150-175 minutes of moderate-intensity exercise spread throughout the week
- Consider traditional Chinese sports like tai chi as an alternative exercise option if conventional exercise programs are not accessible
Frequently asked questions
What type of exercise is best for older adults with type 2 diabetes?
Combined aerobic and resistance exercise showed the greatest benefits for blood sugar control, reducing HbA1c by 1.05% and fasting blood glucose by 1.44 mmol/L compared to no exercise.
How much exercise do older adults with diabetes need for blood sugar benefits?
Significant improvements began at approximately 520 MET-minutes per week for HbA1c and 500 MET-minutes per week for fasting blood glucose, equivalent to about 150-175 minutes of moderate-intensity exercise weekly.
Do all types of exercise help control blood sugar in older adults with diabetes?
Yes, all five exercise types tested significantly reduced HbA1c, including combined exercise, traditional Chinese sports, high-intensity interval training, continuous aerobic exercise, and resistance exercise alone.
Key terms explained
HbA1c (glycated hemoglobin)
A blood test measuring average blood sugar levels over the past 2-3 months; the primary marker for diabetes control
MET-minutes per week
A standardized measure of exercise dose combining intensity and duration; one MET equals resting metabolic rate
Fasting blood glucose
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Source: The optimal exercise modality and dose for glycemic control in older adults with type 2 diabetes mellitus: a systematic review and network meta-analysis. · DOI: doi: 10.3389/fendo.2026.1832624