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Optimal exercise dose for resistance training to improve HbA1c levels in overweight and obese patients with type 2 diabetes: a systematic review of randomized controlled trials and a Bayesian network meta-analysis
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DOI：10.3389/fphys.2026.1867073.png)
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Abstract
En 中文
BackgroundThe high prevalence of overweight or obesity in patients with type 2 diabetes (T2DM) is strongly associated with impaired quality of life and an increased risk of long-term complications. Poor glycemic control remains a fundamental clinical challenge in this population. Although resistance training (RT) is an effective intervention for improving HbA1c levels; the optimal dosing parameters (e.g.; frequency; intensity; volume) have not been systematically established. Therefore; this meta-analysis aimed to investigate the dose-response relationships between various RT regimens and HbA1c reduction in overweight or obese individuals with T2DM.MethodsThis systematic review and network meta-analysis; conducted by searching PubMed; Embase; and the Cochrane Library; included randomized controlled trials on resistance training in patients with T2DM who were overweight or obese; conducted from the inception of the databases through January 19; 2026. Comprehensive data extraction covered training dose; resistance training protocols; participants’ demographic characteristics; and study duration.ResultsA total of 10 studies involving 633 participants (mean age: 60.03 ± 7.77 years; mean BMI: 30.69 ± 6.64; Male: 32.7%) were included in this study. The results of our network meta-analysis showed that resistance training variables (e.g.; frequency; intensity; period; and training volume) were effective in improving HbA1c in overweight or obese patients with T2DM. Among them; the effective dose range for frequency of resistance training was 3 times/week; resistance training intensity was 30-62%; resistance training period was 17–23 weeks; resistance training time was 45 minutes per session; resistance training exercises was 10 exercises per set; resistance training repetitions was 13–18 reps; resistance training sets was 2–4 sets; resistance training volume was 1000–2100 reps per week. the analysis suggested a potential optimum around of resistance training to improve HbA1c in overweight or obese patients with T2DM is 3 times/week (MD=-0.35; 95% CrI [-0.62; -0.08]); 44% 1RM (MD=-0.41; 95% CrI [-0.74; -0.08]); 23 weeks (MD = −0.35; 95% CrI [−0.68; −0.02]); 45min (MD = −0.32; 95% CrI [−0.62; −0.01]); 10 exercises (MD = −0.32; 95% CrI [−0.63; −0.01]); 18 reps (MD=-0.38; 95% CrI [-0.74; -0.02]); 3 sets (MD=−0.36; 95% CrI [−0.63; −0.10]); 1; 500 reps/week (MD = −0.51; 95% CrI [−0.86; −0.15]).ConclusionResistance training effectively improvesHbA1c in overweight or obese patients with T2DM. A recommended 23-week program includes 3 sessions per week at 44% 1RM; 45min per session; featuring 10 exercises per set; 3 sets; and 18 repetitions per exercise; totaling up to 1500 reps weekly.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/; identifier CRD420261341070.
Keywords:
type 2 diabetes
obesity
resistance training
HbA1c
optimal dose
over-weight
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