Abstract
BACKGROUND: Targeting skeletal muscle mass and quality through resistance training (RT) may be a particularly promising approach for treating metabolic diseases. While the benefits of RT in managing type 2 diabetes mellitus (T2DM) are well established, most studies supporting these benefits have been conducted in controlled laboratory or gym settings. To date, it remains unclear whether home-based RT can be as effective as gym-based RT in improving the glycemic profile of patients with T2DM. Therefore, the primary aim of this meta-analysis was to compare the effects of home-based versus gym-based RT on glycemic control (HbA1c) in patients with T2DM. METHODS: A systematic literature search was conducted using SPORTDiscus, PubMed and BISp SURF databases (updated until 2 August 2024). After screening, 20 controlled trials (involving 1397 participants) met the inclusion criteria. RESULTS: A random-effects model revealed a significant effect of RT on glycemic control, with a pooled mean difference favoring RT versus control (mean difference: -0.33; 95% confidence interval (CI): -0.49 to -0.18). Gym-based RT significantly reduced HbA1c compared to control conditions (-0.39; 95% CI: -0.57 to -0.22), while home-based RT showed no significant effect (+0.12; 95% CI: -0.16 to +0.39). Heterogeneity was substantial, suggesting considerable variability between studies. The methodological quality score of the included studies, assessed using the PEDro (Physiotherapy Evidence Database) scale, ranged from 3 to 8, with an average score of 6 ± 1 ("good" quality). CONCLUSIONS: This meta-analysis confirms the effectiveness of RT in reducing HbA1c levels in individuals with T2DM. Notably, the present findings highlight that gym-based RT is effective, while home-based RT is not. Possible reasons include increased motivation by coaches or training buddies in the gym, resulting in increased adherence to the training program, as well as the limited availability of equipment or imprecise load dosing during home workouts. REVIEW REGISTRATION: CRD420250650823.