Comparative Analysis of Cardiovascular Outcomes in Type 2 Diabetes Patients Engaging in Aerobic, Resistance, and Combined Training: A Systematic Review

<b>Background:</b> Among individuals with type 2 diabetes (T2D), cardiovascular disease (CVD) is the leading cause of death, demanding prevention approaches. Exercise is a powerful option for non-pharmacological strategies to improve cardiovascular outcomes. This systematic review aims t...

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Main Authors: Sayed Alireza Mousavi Zadeh, Giuseppe Caminiti, Maurizio Aracri, Massimo Pieri, Anna Paola Mitterhofer, Antonino De Lorenzo, Sergio Bernardini, Pasquale Farsetti, Maurizio Volterrani, Rosario Barone, Ferdinando Iellamo, Marco Alfonso Perrone
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Diabetology
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Online Access:https://www.mdpi.com/2673-4540/6/5/38
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author Sayed Alireza Mousavi Zadeh
Giuseppe Caminiti
Maurizio Aracri
Massimo Pieri
Anna Paola Mitterhofer
Antonino De Lorenzo
Sergio Bernardini
Pasquale Farsetti
Maurizio Volterrani
Rosario Barone
Ferdinando Iellamo
Marco Alfonso Perrone
author_facet Sayed Alireza Mousavi Zadeh
Giuseppe Caminiti
Maurizio Aracri
Massimo Pieri
Anna Paola Mitterhofer
Antonino De Lorenzo
Sergio Bernardini
Pasquale Farsetti
Maurizio Volterrani
Rosario Barone
Ferdinando Iellamo
Marco Alfonso Perrone
author_sort Sayed Alireza Mousavi Zadeh
collection DOAJ
description <b>Background:</b> Among individuals with type 2 diabetes (T2D), cardiovascular disease (CVD) is the leading cause of death, demanding prevention approaches. Exercise is a powerful option for non-pharmacological strategies to improve cardiovascular outcomes. This systematic review aims to evaluate the effects of aerobic, resistance, and combined training on CVD in individuals with T2D. <b>Methods:</b> From 2013 through the end of 2023, PubMed, Scopus, and Web of Science were systematically searched for articles. The studies included 15 articles lasting at least eight weeks and involving 1794 participants each. The cardiac events measured were blood pressure, lipid levels, heart rate variability (HRV), and inflammatory markers such as C-reactive protein (CRP) and interleukin-6 (IL-6). <b>Results:</b> Aerobic training reduced systolic and diastolic blood pressure by 6 mmHg and 3 mmHg, respectively, while significantly enhancing lipid profiles, evidenced by an 8% reduction in LDL cholesterol and a 5% rise in HDL cholesterol. In addition, improvements in lean muscle mass, insulin sensitivity, and slight changes in inflammatory markers support the benefits of resistance training. The most pronounced effects emerged from combined training, which resulted in a 9 mmHg decrease in systolic blood pressure, a 6 mmHg decrease in diastolic pressure, a 10% reduction in LDL cholesterol, a 15% increase in HRV, and a 10% reduction in CRP and IL-6 levels. <b>Conclusions:</b> Combined training has more favorable effects on several key CVD risk factors than aerobic or resistance training alone. It can be regarded as the most effective exercise modality for decreasing CVD risk in adults with T2D.
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spelling doaj-art-a31680a01bcd4103a88db1832fb3080e2025-08-20T02:33:48ZengMDPI AGDiabetology2673-45402025-05-01653810.3390/diabetology6050038Comparative Analysis of Cardiovascular Outcomes in Type 2 Diabetes Patients Engaging in Aerobic, Resistance, and Combined Training: A Systematic ReviewSayed Alireza Mousavi Zadeh0Giuseppe Caminiti1Maurizio Aracri2Massimo Pieri3Anna Paola Mitterhofer4Antonino De Lorenzo5Sergio Bernardini6Pasquale Farsetti7Maurizio Volterrani8Rosario Barone9Ferdinando Iellamo10Marco Alfonso Perrone11Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, 00133 Rome, ItalyDepartment of Human Science and Promotion of Quality of Life, San Raffaele Open University, 00163 Rome, ItalyDepartment of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, 00133 Rome, ItalyDepartment of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, ItalyDepartment of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, ItalyDepartment of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, ItalyDepartment of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, ItalyDepartment of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, 00133 Rome, ItalyDepartment of Human Science and Promotion of Quality of Life, San Raffaele Open University, 00163 Rome, ItalyDepartment of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, 90127 Palermo, ItalyDepartment of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, 00133 Rome, ItalyDepartment of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy<b>Background:</b> Among individuals with type 2 diabetes (T2D), cardiovascular disease (CVD) is the leading cause of death, demanding prevention approaches. Exercise is a powerful option for non-pharmacological strategies to improve cardiovascular outcomes. This systematic review aims to evaluate the effects of aerobic, resistance, and combined training on CVD in individuals with T2D. <b>Methods:</b> From 2013 through the end of 2023, PubMed, Scopus, and Web of Science were systematically searched for articles. The studies included 15 articles lasting at least eight weeks and involving 1794 participants each. The cardiac events measured were blood pressure, lipid levels, heart rate variability (HRV), and inflammatory markers such as C-reactive protein (CRP) and interleukin-6 (IL-6). <b>Results:</b> Aerobic training reduced systolic and diastolic blood pressure by 6 mmHg and 3 mmHg, respectively, while significantly enhancing lipid profiles, evidenced by an 8% reduction in LDL cholesterol and a 5% rise in HDL cholesterol. In addition, improvements in lean muscle mass, insulin sensitivity, and slight changes in inflammatory markers support the benefits of resistance training. The most pronounced effects emerged from combined training, which resulted in a 9 mmHg decrease in systolic blood pressure, a 6 mmHg decrease in diastolic pressure, a 10% reduction in LDL cholesterol, a 15% increase in HRV, and a 10% reduction in CRP and IL-6 levels. <b>Conclusions:</b> Combined training has more favorable effects on several key CVD risk factors than aerobic or resistance training alone. It can be regarded as the most effective exercise modality for decreasing CVD risk in adults with T2D.https://www.mdpi.com/2673-4540/6/5/38type 2 diabetescardiovascular outcomesaerobic exerciseresistance trainingcombined trainingheart rate variability
spellingShingle Sayed Alireza Mousavi Zadeh
Giuseppe Caminiti
Maurizio Aracri
Massimo Pieri
Anna Paola Mitterhofer
Antonino De Lorenzo
Sergio Bernardini
Pasquale Farsetti
Maurizio Volterrani
Rosario Barone
Ferdinando Iellamo
Marco Alfonso Perrone
Comparative Analysis of Cardiovascular Outcomes in Type 2 Diabetes Patients Engaging in Aerobic, Resistance, and Combined Training: A Systematic Review
Diabetology
type 2 diabetes
cardiovascular outcomes
aerobic exercise
resistance training
combined training
heart rate variability
title Comparative Analysis of Cardiovascular Outcomes in Type 2 Diabetes Patients Engaging in Aerobic, Resistance, and Combined Training: A Systematic Review
title_full Comparative Analysis of Cardiovascular Outcomes in Type 2 Diabetes Patients Engaging in Aerobic, Resistance, and Combined Training: A Systematic Review
title_fullStr Comparative Analysis of Cardiovascular Outcomes in Type 2 Diabetes Patients Engaging in Aerobic, Resistance, and Combined Training: A Systematic Review
title_full_unstemmed Comparative Analysis of Cardiovascular Outcomes in Type 2 Diabetes Patients Engaging in Aerobic, Resistance, and Combined Training: A Systematic Review
title_short Comparative Analysis of Cardiovascular Outcomes in Type 2 Diabetes Patients Engaging in Aerobic, Resistance, and Combined Training: A Systematic Review
title_sort comparative analysis of cardiovascular outcomes in type 2 diabetes patients engaging in aerobic resistance and combined training a systematic review
topic type 2 diabetes
cardiovascular outcomes
aerobic exercise
resistance training
combined training
heart rate variability
url https://www.mdpi.com/2673-4540/6/5/38
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