Geriatrics & Gerontology International · Nov 3, 2026
Effect of Exercise Interventions on Sarcopenia‐Related Outcomes in Older Adults With Type 2 Diabetes: A Systematic Review and Meta‐Analysis
By Jafari Harandi A, Tayebi SM, Tartibian B et al.
Aim: To systematically evaluate the effects of exercise interventions on sarcopenia‐related outcomes and glycemic control in older adults with type 2 diabetes ( T2DM ). Methods: We searched PubMed , Scopus, and Cochrane CENTRAL (January 2020–October 2025) for RCTs in adults with T2DM (mean age ≥ 65 years) comparing structured exercise (≥ 4 weeks) with nonexercise control. Co‐primary outcomes were lean/appendicular lean mass, muscle strength, and physical performance; secondary outcomes were HbA1c , FPG , and HOMA ‐ IR . Random‐effects meta‐analyses used Hedges' g for sarcopenia outcomes and mean differences for metabolic outcomes from pre–post changes. Results: Eleven RCTs (≈740 participants) were included. Exercise produced a small, nonsignificant effect on lean mass (6 trials; g = 0.14, 95% CI –0.09 to 0.37; I ² = 0%). Significant moderate‐to‐large improvements were found in muscle strength (nine trials; g = 0.67, 95% CI 0.46–0.88; I ² = 11.7%) and physical performance (nine trials; g = 0.74, 95% CI 0.44–1.03; I ² = 64.4%). HbA1c was reduced by 0.32 percentage points (seven trials; I ² = 0%), HOMA ‐ IR improved by 0.51 units (three trials; I ² = 0%), while FPG changes were small and nonsignificant. Adverse events were rare and no serious exercise‐related complications occurred. Conclusions: In older adults with T2DM , structured exercise training yields meaningful gains in muscle strength, physical performance, and glycemic control despite only modest effects on lean mass. These findings support resistance‐based or multicomponent programs as a core component of care to address both sarcopenia‐related impairments and metabolic abnormalities in this high‐risk population.