Scalable elastic band resistance training improves glycemic control in older adults with type 2 diabetes: A CGM-based randomized crossover study.

OBJECTIVES

To compare the acute and 24-hour glycemic effects of scalable aerobic, elastic-band resistance, and combined training in older adults with type 2 diabetes mellitus using Continuous Glucose Monitoring.

DESIGN

Randomized crossover trial.

METHODS

Thirty older adults with type 2 diabetes mellitus were enrolled, and 23 completed all three exercise sessions and were included in the per-protocol analysis. Interstitial glucose was monitored over 14 days. The non-exercise control condition was the average of four pre-training days. Bonferroni correction was applied to mean glucose, Time in Range, and Glycemic Risk Index. Other Continuous Glucose Monitoring metrics were exploratory. Exploratory Generalized Estimating Equation models compared each condition with control, adjusting for age, sex, body mass index, and HbA1c.

RESULTS

In exploratory analysis, only combined training was associated with lower 24-hour mean glucose versus control (β = -0.513, p = 0.0019, Bonferroni-corrected p = 0.017). No other principal-outcome comparison remained significant after correction. Aerobic training produced the steepest acute glucose decline (-0.0256 mmol/L/min). In secondary pairwise comparisons, combined training had higher Time in Range than aerobic training, while resistance training had lower Glycemic Risk Index than aerobic training after Bonferroni correction. Combined training produced the latest glucose nadir (185 min).

CONCLUSIONS

In exploratory analysis, only combined training significantly reduced 24-hour mean glucose relative to control. Time in Range and Glycemic Risk Index differed by modality in secondary comparisons. Elastic-band resistance training may be a practical, low-cost strategy warranting further study.