Resistance exercise versus aerobic exercise combined with metformin therapy in the treatment of type 2 diabetes: A 12-week comparative clinical study

Background: Both exercise and metformin are used to control blood glucose levels in patients with type 2 diabetes mellitus (T2DM), while no previous studies have investigated the effect of resistance exercise combined with metformin versus aerobic exercise with metformin in T2DM patients. Objectives: This study was conducted to compare the effects of resistance exercise combined with metformin versus aerobic exercise with metformin in T2DM patients. Methods: A total of fifty-seven T2DM patients with a mean age of 46.2±8.3 years were randomized to three study groups; each group included nineteen patients. The first group conducted a resistance exercise program (REP, 50-60% of 1RM, for 40-50 min) combined with metformin, the second group conducted an aerobic exercise program (AEP, 50-70% maxHR, for 40-50 min) combined with metformin, and the third group received only metformin without exercise intervention (Met group). The study program was conducted thrice weekly for consecutive twelve weeks. Fast-ing blood glucose (FBG), glycated hemoglobin (HbA1c), homeostatic model assessment of insulin resistance (HOMA-IR), and maximal oxygen uptake (VO₂ max) were evaluated before and after study intervention. Results: Significant differences were reported after the 12-week intervention inter-groups in the outcome variables (p˂0.05). FBG, HbA1c, HOMA-IR, and VO₂ max improved significantly in the REP group (p˂0.001) and also in the AEP group (p=0.016, p=0.036, p=0.024, and p=0.019 respec-tively) while the Met group showed an only significant reduction in FBG (p=0.049), and non-signif-icant changes in HbA1c, HOMA-IR, and VO₂ max (p˃0.05). REP group achieved greater improve-ments than AEP group (FBG, p=0.034; HbA1c%, p=0.002; HOMA-IR, p˂0.001; and VO₂ max, p=0.024). Conclusion: Both resistance and aerobic exercise programs combined with metformin are effective in controlling T2DM. Resistance exercise combined with metformin is more effective than aerobic exercise combined with metformin in the treatment of T2DM. Trial Registration: This study is retrospectively registered in www.clinicaltrials.gov (ID: NC-T05004948).