What is it about?
This study examines how different types of structured exercise influence health outcomes in adults with type 2 diabetes. Specifically, it compares combined aerobic and resistance training with high-intensity interval training over a 12-week period, and evaluates whether either approach offers advantages over usual medical care alone. Type 2 diabetes is closely linked to poor blood sugar control, reduced insulin sensitivity, excess body fat, declining physical function, and reduced quality of life. Exercise is widely recommended as part of diabetes management. However, there is limited direct evidence comparing different exercise formats across both clinical outcomes and patient-reported outcomes. This study addresses that gap. Participants were randomly allocated to one of three groups. One group undertook moderate-intensity aerobic exercise combined with resistance training. A second group completed high-intensity interval training, involving short bursts of vigorous activity alternated with recovery periods. The control group continued with standard care without a structured exercise programme. The researchers assessed changes in blood sugar levels, long-term glucose control, insulin resistance, body composition, walking capacity, and quality of life. Both exercise programmes led to meaningful improvements compared with standard care. High-intensity interval training produced greater reductions in fasting blood glucose and larger gains in muscle mass. In contrast, combined aerobic and resistance training resulted in broader improvements in long-term blood sugar control, reductions in body fat, and multiple domains of quality of life. Overall, the study demonstrates that regular, structured exercise significantly improves metabolic health, physical function, and wellbeing in people with type 2 diabetes. It also highlights that different exercise approaches may be selected based on individual goals, preferences, and clinical priorities, supporting a personalised approach to exercise prescription in diabetes care.
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Why is it important?
This study is important because it provides clear, comparative evidence on how different exercise approaches can be used strategically to manage type 2 diabetes, a condition with rising global prevalence and substantial long-term health and economic consequences. Type 2 diabetes is associated not only with poor blood glucose control, but also with insulin resistance, excess adiposity, reduced physical capacity, and impaired quality of life. While exercise is universally recommended as a cornerstone of diabetes management, clinicians and patients are often uncertain about which type of exercise is most effective for specific outcomes. This study directly addresses that uncertainty by comparing two widely used, but physiologically distinct, exercise modalities within a randomised controlled design. Its importance lies in three key areas. First, it demonstrates that structured exercise produces clinically meaningful improvements beyond usual care, reinforcing exercise as an essential, evidence-based intervention rather than an optional lifestyle adjunct. Second, it shows that different exercise modalities confer different benefits. High-intensity interval training was more effective for improving fasting blood glucose and muscle mass, whereas combined aerobic and resistance training led to broader improvements in long-term glycaemic control, fat reduction, and multiple domains of quality of life. This nuanced evidence supports personalised exercise prescription, rather than a one-size-fits-all approach. Third, the study integrates patient-centred outcomes, such as functional capacity and quality of life, alongside biochemical markers. This is critical because successful diabetes management depends not only on metabolic control, but also on physical function, psychological wellbeing, and long-term adherence. Overall, the study strengthens the case for tailored, goal-directed exercise programmes in routine diabetes care and provides practical evidence to guide clinicians, physiotherapists, and exercise professionals in optimising treatment strategies.
Perspectives
From an academic and clinical perspective, this publication makes a meaningful and timely contribution to the evidence base on exercise as a core therapeutic strategy for type 2 diabetes. First, the study is methodologically robust. The use of a randomised controlled design, covariate-adjusted mixed models, and transparent reporting aligned with CONSORT guidance strengthens internal validity and enhances confidence in the findings. Importantly, the integration of multiple outcomes. Metabolic, functional, body composition, and quality of life. Moves beyond a narrow biomedical focus and reflects contemporary expectations of person-centred research in long-term conditions. Second, the paper advances clinical relevance by offering comparative, rather than isolated, evidence. Many previous studies have examined aerobic training, resistance training, or HIIT in isolation. By directly comparing combined aerobic–resistance training with HIIT, the study addresses a genuine gap faced by clinicians when translating exercise guidelines into practice. The differentiated pattern of benefits observed across outcomes provides a strong rationale for tailored exercise prescription, which aligns well with modern rehabilitation and self-management frameworks. Third, the inclusion of quality-of-life outcomes is a notable strength. Demonstrating improvements in physical, psychological, social, and environmental domains reinforces the argument that exercise is not solely a metabolic intervention, but a holistic strategy that supports long-term engagement and wellbeing. This is particularly relevant for physiotherapy-led and multidisciplinary diabetes services. From a scholarly perspective, the publication also positions future research clearly. It highlights the need for longer-term follow-up, hybrid training models, and more precise body composition assessment, thereby setting a coherent agenda for subsequent trials and implementation studies. Overall, this publication strengthens your academic profile by combining methodological rigour, clinical applicability, and patient-centred outcomes, and it contributes evidence that is directly translatable to practice and guideline development in diabetes care.
Sampath Kumar Amaravadi
University of Birmingham
Read the Original
This page is a summary of: Comparative effects of combined aerobic and resistance training versus high-intensity interval training on insulin resistance, glycaemic control, body composition and quality of life in type 2 diabetes: A 12-week randomised controlled trial, PLOS One, December 2025, PLOS,
DOI: 10.1371/journal.pone.0336898.
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