Comparative effectiveness of different exercise modality on glycaemic control and lipid profile for prediabetes: systematic review and network meta-analysis

BackgroundPrediabetes is the precursor to type 2 diabetes and represents a critical, reversible window for intervention. This study aims to systematically review and conduct a network meta-analysis to evaluate the efficacy of aerobic training (AT), resistance training (RT), combined training (AT+RT)...

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Main Authors: Ruixiang Yan, Lunxin Chen, Gesheng Lin, Yuer Shi, Wenrui Huang, Yuqiang Mai, Jian Sun, Duanying Li
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Endocrinology
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Online Access:https://www.frontiersin.org/articles/10.3389/fendo.2025.1518871/full
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author Ruixiang Yan
Lunxin Chen
Gesheng Lin
Yuer Shi
Wenrui Huang
Yuqiang Mai
Jian Sun
Jian Sun
Duanying Li
Duanying Li
author_facet Ruixiang Yan
Lunxin Chen
Gesheng Lin
Yuer Shi
Wenrui Huang
Yuqiang Mai
Jian Sun
Jian Sun
Duanying Li
Duanying Li
author_sort Ruixiang Yan
collection DOAJ
description BackgroundPrediabetes is the precursor to type 2 diabetes and represents a critical, reversible window for intervention. This study aims to systematically review and conduct a network meta-analysis to evaluate the efficacy of aerobic training (AT), resistance training (RT), combined training (AT+RT), high-intensity interval training (HIIT), and traditional Chinese exercises (TCEs) on glycemic control, lipid profile, and weight management in prediabetic individuals. This marks the first time HIIT and TCEs have been included in such an assessment.MethodsA systematic search was conducted across PubMed, Web of Science, Cochrane (CENTRAL), Embase, CNKI, and WangFang Data for randomized controlled trials (RCTs) on the effects of different exercise modalities on prediabetic patients published up to August 10, 2024. Network meta-analysis was performed using the “gemtc” package in R software, and the quality of evidence was assessed using the CINeMA framework.ResultsA total of 74 studies involving 5,683 participants were included. The network meta-analysis results showed that HIIT was the most effective for reducing haemoglobin A1c (HbA1c) (-0.44%, 95% CI: -0.55% to -0.32%, SUCRA 93.8%), 2-hour plasma glucose (2hPG) (-1.3, 95% CI: -1.6 to -0.93, SUCRA 84.3%), and increasing high-density lipoprotein (HDL) (0.20, 95% CI: 0.03 to 0.36, SUCRA 87.3%). AT+RT was most effective in reducing total cholesterol (TC) (-0.46, 95% CI: -0.61 to -0.32, SUCRA 98.3%), TG (-0.55, 95% CI: -0.69 to -0.42, SUCRA 99.9%), low-density lipoprotein (LDL) (-0.35, 95% CI: -0.53 to -0.18, SUCRA 82.2%), and body mass index (BMI) (-0.89, 95% CI: -1.6 to -0.14, SUCRA 66.4%). TCEs showed the most significant improvements in reducing 2hPG (-1.3, 95% CI: -1.5 to -1.0, SUCRA 83.5%), body weight (BW) (-3.4, 95% CI: -6.4 to -0.51, SUCRA 79.1%), and wasit circumference (WC) (-4.27, 95% CI: -7.53 to -0.98, SUCRA 84.6%).ConclusionVarious exercise interventions significantly improved glycemic and lipid profiles in prediabetic patients. HIIT and AT+RT were found to be the most effective interventions. For elderly individuals with limited physical activity or chronic conditions, TCEs can serve as a gentle and safe alternative. These findings provide the latest evidence to support exercise interventions for managing prediabetes.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42024578405.
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spelling doaj-art-1c0a47fbb0704373aa9ec4e6518eb9b82025-08-20T03:56:00ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-07-011610.3389/fendo.2025.15188711518871Comparative effectiveness of different exercise modality on glycaemic control and lipid profile for prediabetes: systematic review and network meta-analysisRuixiang Yan0Lunxin Chen1Gesheng Lin2Yuer Shi3Wenrui Huang4Yuqiang Mai5Jian Sun6Jian Sun7Duanying Li8Duanying Li9School of Athletic Training, Guangzhou Sport University, Guangzhou, ChinaSchool of Physical Education and Sport, Central China Normal University, Wuhan, ChinaSchool of Athletic Training, Guangzhou Sport University, Guangzhou, ChinaSchool of Athletic Training, Guangzhou Sport University, Guangzhou, ChinaThe Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, Guangdong, ChinaSchool of Wushu, Guangzhou Sport University, Guangzhou, ChinaSchool of Athletic Training, Guangzhou Sport University, Guangzhou, ChinaGuangdong Provincial Key Laboratory of Human Sports Performance Science, Guangzhou, ChinaSchool of Athletic Training, Guangzhou Sport University, Guangzhou, ChinaGuangdong Provincial Key Laboratory of Human Sports Performance Science, Guangzhou, ChinaBackgroundPrediabetes is the precursor to type 2 diabetes and represents a critical, reversible window for intervention. This study aims to systematically review and conduct a network meta-analysis to evaluate the efficacy of aerobic training (AT), resistance training (RT), combined training (AT+RT), high-intensity interval training (HIIT), and traditional Chinese exercises (TCEs) on glycemic control, lipid profile, and weight management in prediabetic individuals. This marks the first time HIIT and TCEs have been included in such an assessment.MethodsA systematic search was conducted across PubMed, Web of Science, Cochrane (CENTRAL), Embase, CNKI, and WangFang Data for randomized controlled trials (RCTs) on the effects of different exercise modalities on prediabetic patients published up to August 10, 2024. Network meta-analysis was performed using the “gemtc” package in R software, and the quality of evidence was assessed using the CINeMA framework.ResultsA total of 74 studies involving 5,683 participants were included. The network meta-analysis results showed that HIIT was the most effective for reducing haemoglobin A1c (HbA1c) (-0.44%, 95% CI: -0.55% to -0.32%, SUCRA 93.8%), 2-hour plasma glucose (2hPG) (-1.3, 95% CI: -1.6 to -0.93, SUCRA 84.3%), and increasing high-density lipoprotein (HDL) (0.20, 95% CI: 0.03 to 0.36, SUCRA 87.3%). AT+RT was most effective in reducing total cholesterol (TC) (-0.46, 95% CI: -0.61 to -0.32, SUCRA 98.3%), TG (-0.55, 95% CI: -0.69 to -0.42, SUCRA 99.9%), low-density lipoprotein (LDL) (-0.35, 95% CI: -0.53 to -0.18, SUCRA 82.2%), and body mass index (BMI) (-0.89, 95% CI: -1.6 to -0.14, SUCRA 66.4%). TCEs showed the most significant improvements in reducing 2hPG (-1.3, 95% CI: -1.5 to -1.0, SUCRA 83.5%), body weight (BW) (-3.4, 95% CI: -6.4 to -0.51, SUCRA 79.1%), and wasit circumference (WC) (-4.27, 95% CI: -7.53 to -0.98, SUCRA 84.6%).ConclusionVarious exercise interventions significantly improved glycemic and lipid profiles in prediabetic patients. HIIT and AT+RT were found to be the most effective interventions. For elderly individuals with limited physical activity or chronic conditions, TCEs can serve as a gentle and safe alternative. These findings provide the latest evidence to support exercise interventions for managing prediabetes.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42024578405.https://www.frontiersin.org/articles/10.3389/fendo.2025.1518871/fullprediabetesglycaemiclipid profileexerciseweight
spellingShingle Ruixiang Yan
Lunxin Chen
Gesheng Lin
Yuer Shi
Wenrui Huang
Yuqiang Mai
Jian Sun
Jian Sun
Duanying Li
Duanying Li
Comparative effectiveness of different exercise modality on glycaemic control and lipid profile for prediabetes: systematic review and network meta-analysis
Frontiers in Endocrinology
prediabetes
glycaemic
lipid profile
exercise
weight
title Comparative effectiveness of different exercise modality on glycaemic control and lipid profile for prediabetes: systematic review and network meta-analysis
title_full Comparative effectiveness of different exercise modality on glycaemic control and lipid profile for prediabetes: systematic review and network meta-analysis
title_fullStr Comparative effectiveness of different exercise modality on glycaemic control and lipid profile for prediabetes: systematic review and network meta-analysis
title_full_unstemmed Comparative effectiveness of different exercise modality on glycaemic control and lipid profile for prediabetes: systematic review and network meta-analysis
title_short Comparative effectiveness of different exercise modality on glycaemic control and lipid profile for prediabetes: systematic review and network meta-analysis
title_sort comparative effectiveness of different exercise modality on glycaemic control and lipid profile for prediabetes systematic review and network meta analysis
topic prediabetes
glycaemic
lipid profile
exercise
weight
url https://www.frontiersin.org/articles/10.3389/fendo.2025.1518871/full
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