Jenna Krueger

Background:  Diabetes mellitus and hypertension are highly prevalent in the United States, affecting around 31.6% and 12.5% of adults, respectively, and contributing significantly to cardiovascular disease. Resistance training has gained attention as an effective nonpharmacologic intervention; however, variability exists in the literature regarding its comparative benefits and optimal implementation. While exercise is widely recommended, gaps remain in understanding the specific role of resistance training in improving glycemic control and cardiovascular outcomes. This review aims to synthesize current evidence on resistance training in individuals with type 2 diabetes or hypertension.

Methods. A targeted review of selected peer-reviewed studies was conducted, including randomized controlled trials, cohort studies, and experimental interventions. Key search terms included resistance training, type 2 diabetes (T2D), hypertension, HbA1c, and cardiovascular outcomes.

Results.  Resistance training consistently improved glycemic control, with reductions in hemoglobin A1c comparable to or greater than aerobic exercise. Two studies that followed the same experimental design  (one from Diabetelogia and one from JAMA) and used a similar sample size (n=186 and n=262) found overall that resistance exercise lowered Hemoglobin A1C (HbA1C). However, the Diabetelogia study found resistance training only lowered HbA1C most significantly while the JAMA study found combined resistance and aerobic training lowered HbA1C most significantly. Other notable studies found combined resistance and aerobic training improved other glycemic markers like Asprosin and Insulin Resistance as well as particularly improving HbA1C in patients older than 65 with chronic T2D. Key limitations of these clinical trials include high potential for confounding factors and reliance on compliance. A Journal of Sport and Health Sciences attempted to account for these limitations by performing a study on mice subjects. The study found resistance training significantly increased insulin resistance via direct measurements of biomolecules in muscle as compared to aerobic training.  Clinically, it is safest to recommend patients to use both resistance and aerobic training. Additionally, resistance training was studied in patients with hypertension and resulted in reductions in blood pressure, improved endothelial function, enhanced heart rate variability, and increased high-density lipoprotein cholesterol. Supervised programs were more effective than usual care, and technology-assisted interventions improved adherence and health outcomes.

Conclusions.  Resistance training is an effective strategy for improving metabolic and cardiovascular health in individuals with type 2 diabetes and hypertension. Use of technological tracking interventions also showed improved outcomes. It is clinically acceptable to implement in treatment plans. Future research should focus on optimizing training protocols and improving long-term adherence.

Works Cited 

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