Effects of Combined Diet and Physical Activity on Glycemic Control and Body Composition in Male Recreational Athletes with Type 2 Diabetes Mellitus

Kayri Chouk¹Raoua Triki¹Ismail Dergaa¹Halil İbrahim CEYLAN^2*Houda Bougrine³Muntean Raul Ioan^4*Abderraouf Ben Abderrahman¹

• ¹Higher Institute of Sport and Physical Education of Ksar Saïd, University of Manouba, Tunis, Tunis, Tunisia
• ²Atatürk University, Erzurum, Türkiye
• ³University of Gafsa, Gafsa, Tunisia
• ⁴1 Decembrie 1918 University, Alba Iulia, Romania

Type 2 diabetes Mellitus (T2DM) is associated with metabolic and cardiovascular complications, which may be mitigated through lifestyle interventions. Physical activity and dietary modifications are recognized as cornerstones of diabetes management. However, the combined effects of these interventions, particularly in active male populations, remain underexplored. This study aimed to assess the effects of a 12-week therapeutic diet and/or physical activity program on body composition and biochemical parameters in male recreational athletes with type 2 diabetes. Thirty-six male recreational athletes (aged 30-45 years) with type 2 diabetes were randomly assigned to one of four groups: (1) Physical Activity (PA), (2) Nutritional Regimen (NR), (3) Combined PA and NR (PA+NR), and (4) Control (CG). Interventions lasted 12 weeks, with body composition (body mass, body fat percentage, and muscle mass) and biochemical markers (fasting blood sugar [FBS], glycated hemoglobin [HbA1c], low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], and insulin resistance [HOMA-IR]) measured at baseline (T0), midpoint (T1), and end of the intervention (T2). The PA+NR group showed significant reductions in body mass (p<0.05, ES=0.29), body fat percentage (p<0.05, ES=0.31), and increases in muscle mass (p<0.05, ES=0.35) at T1 and T2 compared to T0.Biochemical markers improved significantly in the PA+NR group, with reductions in FBS (p<0.05, ES=0.17), HbA1c (p<0.05, ES=0.23), and LDL-C (p<0.05, ES=0.17), as well as an increase in HDL-C (p<0.05, ES=0.29). Insulin resistance (OMA) significantly decreased in the PA+NR group (p<0.05, ES=0.39). In contrast, the PA group displayed only HbA1c reductions (p<0.05, ES=0.25), while the NR group primarily improved LDL-C (p<0.05, ES=0.24) and HDL-C (p<0.05, ES=0.28) levels. No significant changes were noted in the control group. A combined therapeutic diet and physical activity program effectively improved body composition and biochemical parameters in recreational athletes with T2DM. This combined intervention could be recommended as an integral approach for diabetes management in physically active individuals