Canadian Journal of Diabetes · Feb 24, 2026

Impact of Biological Sex on Physical Function After 16-Week Elastic-band Resistance Training Along With Diabetes Education in Older Men and Women With Type 2 Diabetes Mellitus and Frailty

By Eberts QR, Thomson AM, Peskett LE et al.

OBJECTIVES: Older adults living with type 2 diabetes mellitus (T2DM) and frailty have greater physical function impairment than those with either condition alone. Women have disproportionately worse outcomes, including reduced physical function, higher glycated hemoglobin (A1C), and greater frailty. However, little is known about sex effects on physical function after elastic-band training with diabetes education. In this study we aimed to determine how sex influences physical function after 16-week elastic-band resistance training combined with T2DM education in older adults living with T2DM and frailty. METHODS: Participants (n=182) included in the Band-Frail program were: 1) ≥65 years of age; 2) living with T2DM or with an A1C ≥6.5%; and 3) were at least pre-frail based on the Fried Frailty Scale. The intervention was a 16-week elastic-band resistance training twice per week and T2DM education once per week. The primary outcome was physical function (Short Physical Performance Battery: score 0 to 12), with secondary outcomes of A1C, and frailty score (1 to 5). RESULTS: Intention-to-treat assessment revealed significant changes for physical function (β=0.83, 95% confidence interval [CI] 0.28% to 1.37%; p=0.004), A1C (β=-0.28, 95% CI -0.53% to -0.03%; p=0.03), and frailty (β=-0.49, 95% CI -0.73% to -0.24%; p<0.01). A significant time × sex interaction (β=0.70, 95% CI 0.07% to 1.33%; p=0.028) was observed for physical function, with women improving by 0.70 point more than men after completion of the 16-week intervention. CONCLUSIONS: Biological sex impacts the change in physical function after a 16-week elastic-band resistance training program and T2DM education in older adults living with T2DM and frailty.

doi.org/10.1016/j.jcjd.2026.02.005Open accessPubMed 41747963Interventions