Impact of physical activity on visual outcomes among persons with type 2 diabetes: A scoping review of randomized controlled trials

Dialogues in health Pub Date : 2026-06-01 Epub Date: 2026-05-24 DOI:10.1016/j.dialog.2026.100314

Thomas Hormenu , Ebenezer Oduro Antiri , Stephen Ocansey , Edward Wilson Ansah

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Abstract

Purpose

The global burden of Type 2 diabetes mellitus (T2DM) is increasing, with diabetic eye complications remaining a leading cause of irreversible blindness. Current evidence suggests that physical activity may help mitigate diabetes-related microvascular complications. This scoping review synthesized evidence from randomized controlled trials (RCTs) assessing the impact of physical activity interventions on visual outcomes in individuals living with T2DM.

Methods

Using the JBI framework, a search of MEDLINE, CENTRAL, SCOPUS, JSTOR, and clinical trial registries was conducted yielding 3634 records, of which 8 RCTs satisfied the inclusion criteria. The included studies were conducted across 8 countries with varied designs, intervention protocols, outcome measures, and study durations.

Results

The findings revealed mixed outcomes regarding how physical activity affects visual outcomes. Of the 8 included RCTs, 4 reported beneficial effects (including significant decreases in central macular thickness, reduced risk of retinal microaneurysm formation, and lower diabetic retinopathy incidence or progression), 3 reported no significant effect, and 1 reported an unanticipated increase in retinopathy incidence in intervention groups. This review highlights critical gaps, including the lack of standardised visual outcome measurements, insufficient exploration of contrast sensitivity, colour vision, and visual fields, and limited or no follow-ups. Additionally, adherence to physical activity interventions may have been influenced by social determinants of health, such as socioeconomic status, cultural factors, and healthcare accessibility.

Conclusion

This review highlights the need for further high-quality RCTs with standardised physical activity protocols and comprehensive visual assessments. The findings offer a basis for incorporating structured physical activity into diabetes care, especially in resource-limited settings.

Registration

The scoping review is registered with Open Science Framework (https://doi.org/10.17605/OSF.IO/856YB).

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体育活动对2型糖尿病患者视力结果的影响：随机对照试验的范围综述

目的：2型糖尿病（T2DM）的全球负担正在增加，糖尿病性眼部并发症仍然是不可逆失明的主要原因。目前的证据表明，体育活动可能有助于减轻糖尿病相关的微血管并发症。本综述综合了来自随机对照试验（rct）的证据，评估了体育活动干预对T2DM患者视力结果的影响。方法：采用JBI框架，检索MEDLINE、CENTRAL、SCOPUS、JSTOR和临床试验注册库，得到3634条记录，其中8项rct符合纳入标准。纳入的研究在8个国家进行，采用不同的设计、干预方案、结果测量和研究持续时间。结果：研究结果揭示了关于体育活动如何影响视力结果的混合结果。在纳入的8项随机对照试验中，4项报告了有益的效果（包括显著降低黄斑中央厚度，降低视网膜微动脉瘤形成的风险，降低糖尿病视网膜病变的发病率或进展），3项报告无显著效果，1项报告了干预组视网膜病变发病率的意外增加。这篇综述强调了关键的差距，包括缺乏标准化的视觉结果测量，对对比敏感度、色觉和视野的探索不足，以及随访有限或没有随访。此外，坚持身体活动干预可能受到健康的社会决定因素的影响，如社会经济地位、文化因素和医疗保健可及性。结论：本综述强调需要进一步开展高质量的随机对照试验，采用标准化的体育活动方案和全面的视觉评估。研究结果为将有组织的体育活动纳入糖尿病护理提供了基础，特别是在资源有限的情况下。注册：范围审查已在Open Science Framework （https://doi.org/10.17605/OSF.IO/856YB）注册。

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