Resistance Training for Improving HbA1c in Overweight or Obese Patients with Type 2 Diabetes: A Systematic Review and Network Meta-Analysis

The 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 have not been systematically established. Therefore, this systematic review and network meta-analysis aimed to investigate the dose-response relationships between various RT regimens and HbA1c reduction in overweight or obese individuals with T2DM.

This systematic review and network meta-analysis was conducted by searching PubMed, Embase, and the Cochrane Library, including 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.

A 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, and 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]), and 1,500 reps/week (MD = −0.51, 95% CrI [−0.86, −0.15]).

In conclusion, resistance training effectively improves HbA1c 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.

This systematic review and network meta-analysis highlights the importance of resistance training in improving glycemic control in patients with T2DM. However, it is essential to note that this analysis was limited by the availability of data and the heterogeneity of study designs. Further research is necessary to establish more definitive dosing parameters for RT in this population.

Research Use Only: This systematic review and network meta-analysis should not be used as a basis for clinical decision-making without consulting relevant literature and expert opinion. Peptides-pro RUO/Laboratory Peptides are intended for research use only and should not be used for human subjects or therapeutic purposes without proper authorization and regulatory compliance.