DOI: 10.1111/ggi.70877 ISSN: 1444-1586
Effect of Exercise Interventions on Sarcopenia‐Related Outcomes in Older Adults With Type 2 Diabetes: A Systematic Review and Meta‐Analysis
Amirhossein Jafari Harandi, Seyed Morteza Tayebi, Bakhtyar Tartibian, Rasoul Eslami ABSTRACT
Aim
To systematically evaluate the effects of exercise interventions on sarcopenia‐related outcomes and glycemic control in older adults with type 2 diabetes (
T2DM
).
Methods
We searched
PubMed
, Scopus, and Cochrane
CENTRAL
(January 2020–October 2025) for
RCTs
in adults with
T2DM
(mean age ≥ 65 years) comparing structured exercise (≥ 4 weeks) with nonexercise control. Co‐primary outcomes were lean/appendicular lean mass, muscle strength, and physical performance; secondary outcomes were
HbA1c
,
FPG
, and
HOMA
‐
IR
. Random‐effects meta‐analyses used Hedges'
g
for sarcopenia outcomes and mean differences for metabolic outcomes from pre–post changes.
Results
Eleven
RCTs
(≈740 participants) were included. Exercise produced a small, nonsignificant effect on lean mass (6 trials;
g
= 0.14, 95%
CI
–0.09 to 0.37;
I
2
= 0%). Significant moderate‐to‐large improvements were found in muscle strength (nine trials;
g
= 0.67, 95%
CI
0.46–0.88;
I
2
= 11.7%) and physical performance (nine trials;
g
= 0.74, 95%
CI
0.44–1.03;
I
2
= 64.4%).
HbA1c
was reduced by 0.32 percentage points (seven trials;
I
2
= 0%),
HOMA
‐
IR
improved by 0.51 units (three trials;
I
2
= 0%), while
FPG
changes were small and nonsignificant. Adverse events were rare and no serious exercise‐related complications occurred.
Conclusions
In older adults with
T2DM
, structured exercise training yields meaningful gains in muscle strength, physical performance, and glycemic control despite only modest effects on lean mass. These findings support resistance‐based or multicomponent programs as a core component of care to address both sarcopenia‐related impairments and metabolic abnormalities in this high‐risk population.