The effects of resistance training on glycemic control, cardiometabolic health, and body composition in middle-aged and older women with type 2 diabetes and overweight or obesity: A systematic review and meta-analysis

Objective

To explore the effects of resistance training on glycemic control, cardiometabolic markers, and body composition in women with overweight or obesity who are middle-aged or older and have type 2 diabetes mellitus.

Methods

Following the guidelines on Preferred Reporting Items for Systematic Reviews and Meta-Analyses, we searched CINAHL, PubMed, MEDLINE, and EMBASE for randomized controlled trials published in English up to May 2025. Eligible studies included resistance training interventions for women with a body mass index of 25 kg/m² or more and type 2 diabetes, with a mean participant age of 45 years or older. Random-effects meta-analyses were conducted using Review Manager software, with subgroup analyses to address heterogeneity.

Results

Thirteen trials with a total of 315 participants were included. Resistance training significantly reduced fasting glucose (mean difference − 20.70 mg per deciliter, 95 % CI -33.65 to −7.75, p = 0.002), glycated hemoglobin (mean difference −0.66 %, 95 % CI −1.01 to −0.33, p = 0.0002), total cholesterol, low-density lipoprotein cholesterol, diastolic blood pressure, body mass index, and body fat percentage. No significant effects were observed for triglycerides, high-density lipoprotein cholesterol, systolic blood pressure, or body weight. Greater reductions in fasting glucose were observed with training intensity above 70 % of one-repetition maximum.

Conclusions

Resistance training is effective in improving glycemic control, certain cardiometabolic risk factors, and body composition in this population. These findings support its role as a targeted intervention and highlight the need for further research to refine its application.