Abstract
AIMS: This study was aimed at evaluating the effectiveness of traditional Chinese exercises (TCEs) in improving both physical and psychological health in individuals with prediabetes. METHODS: Randomized controlled trials were systematically searched in the Cochrane Library, PubMed, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), Wanfang, VIP, and the Chinese Biomedical Literature Database (CBM) up to August 28, 2025. Data from 22 trials involving 1854 participants were analyzed using Stata 15.0. The risk of bias was assessed with the Cochrane RoB 2.0 tool. RESULTS: TCEs significantly improved fasting blood glucose (FBG), insulin resistance, glycated hemoglobin (HbA1c), 2-h postprandial blood glucose (2hPG), and several psychological outcomes compared with controls. Subgroup analyses showed consistent improvements in FBG at 3, 6, and 12 months, although the effect size and heterogeneity varied across time points. HbA1c and 2hPG improved at 3 and 6 months, while fasting insulin changes were significant only at 3 months. Baduanjin and Qigong were most effective for metabolic outcomes, whereas evidence for Taiji was limited and inconclusive, though some studies suggested potential benefits for HbA1c. Psychological benefits were observed across all exercise types. CONCLUSION: TCEs may enhance metabolic regulation and psychological well-being in individuals with prediabetes, potentially reducing the risk of progression to Type 2 diabetes. However, due to high heterogeneity and small sample sizes for some outcomes, these findings should be interpreted with caution. Large, well-designed multicenter trials are warranted to confirm these effects.