Cardio plus weights calmed inflammation in type 2 diabetes

Aerobic training on its own and resistance training on its own each appear to help with blood sugar control, chronic low-grade inflammation, resting cardiovascular function and mental health in people carrying excess weight with type 2 diabetes. The obvious next question is what happens when the two are combined, since most exercise guidance now recommends doing both. This review set out to gather everything known about combined aerobic and resistance training in this specific population, across a deliberately broad set of outcomes spanning glycaemic control, blood pressure, inflammation, fitness and quality of life.

The researchers searched six databases from inception up to May 2023 for eligible trials, assessed them with the Cochrane risk of bias tool, and graded the reliability of the evidence. From 21,612 records retrieved, 20 studies were included, contributing data from 1,192 participants with a mean age of 57. Results were pooled using a random-effects model, and the protocol was registered in advance on an international registry, which guards against outcomes being cherry-picked after the fact.

Combined training produced significant improvements across a wide sweep of measures: body mass index, glycated haemoglobin, systolic and diastolic blood pressure, cardiorespiratory fitness and quality of life all moved favourably. Inflammation shifted too, with reductions in C-reactive protein, tumour necrosis factor-alpha and interleukin-6. Not everything changed: resting heart rate showed no difference between the comparisons. The authors are candid about the weaknesses, reporting an uncertain risk of bias and poor quality of evidence among the included studies, which tempers how firmly any single effect can be stated.

This extends the single-mode exercise literature by showing that the combined approach touches an unusually broad range of outcomes at once, including inflammatory markers and quality of life, which are less commonly reported than blood sugar. It supports the framing of structured exercise as a core element of diabetes management rather than an optional extra. The open questions the authors name are the dose-response relationship, how the training should be configured, and the mechanisms behind the adaptations, all of which need trials with stronger methodological design.

If you have type 2 diabetes alongside excess weight, or are close to someone who does, this is a reason to think a programme mixing cardio and strength work addresses more than one problem at a time: blood sugar, blood pressure, inflammation, fitness and how life actually feels. It is not proof of how large those benefits are, because the evidence quality was rated poor. The direction of travel, though, was consistent across a substantial pool of trials.