Impact of Resistance Training depending on the initial severity of type 2 diabetes – A systemic review and an evidence-based guidelines

Elboim-Gabyzon M1. Mendelevich H2
1Physical Therapy Department, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
2 Tirat Hacarmel Physical Therapy Clinics, Haifa and Upper Galilee district, Clalit Health Services



Background: Resistance training, which is a type of an anaerobic training ,leads to positive metabolic and physiological changes among patients with type 2 diabetes. Resistance training can be personalized for patients who are beginning to change their routine physical activity level and lifestyle, because its implementation requires a limited number of short training sessions per week. To the best of our knowledge, there is no systematic review regarding the efficiency of resistance training depending on the initial severity of type 2 diabetes.


Objective: Review the literature regarding the efficacy of resistance training for diabetic patients depending on the initial severity of the disease, aasdetermined by glycated hemoglobin
(HbA1c)level. Another goal is the formulation of evidence-based guidelines for creating a resistance training program customized for patients with diabetes according to disease severity, weight, waist circumference, gender and age.


Methods: A systematic review of the literature in the following databases: PubMed, CINAHL, PEDro, Elsevier, The Cochrane Library, Google Scholar and Medline was performed. Search terms included: diabetes, diabetes mellitus, type 2 diabetes, resistance training, resistance exercises and exercise. Inclusion criteria were randomized controlled trials dealing with resistance training for muscle strength in patients with type 2 diabetes, ages 18 and older. Studies with low methodological quality, defined as a score less than 6/10 on the PEDro assessment scale were not included.


Results: The literature review found ten articles that met the inclusion criteria. Resistance training has been shown to be effective in reducing HbA1c levels in patients with mild or moderate illnessseverity (HbA1c up to 8.9%). The recommended program includes training with fitness machines for 35-50 minutes at 70% to 85% effort, under the supervision of a therapist, for 12 weeks, for three sessions a week (on non-consecutive days)..


Conclusions: The findings of this review indicatethat resistance training is recommended for type 2 diabetes patients with mild to moderate disease severity, who are 60 years-old on average, obese, with a waist circumference of 100 cm, who do not suffer from other illnesses or secondary complications of diabetes. This training has been shown to be effective in lowering HbA1c levels. Based on the findings of the review, optimal dose and training intensity can be recommended. However, research is lacking regarding evidence proving the effectiveness of resistance training for patients with diabetes based on the gender and age of the individual.


Keywords: anaerobic training, resistance training, type 2 diabetes, HbA1c level

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