SYSTEMATIC REVIEW article
Front. Endocrinol.
Sec. Clinical Diabetes
This article is part of the Research TopicImpacts of Physical Activity and Exercise on Metabolic DisordersView all articles
Mind–Body Exercise for Improving Balance, Aerobic Capacity, Walking Ability, Muscle Strength, and Mental Health in Patients with Type 2 Diabetes: A Network Meta-Analysis
Provisionally accepted
- 1Myongji University - Natural Science Campus, Yongin-si, Republic of Korea
- 2Shandong Sport University, Jinan, China
- 3University of Jinan, Jinan, China
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Abstract Objective: To compare and rank the effects of different mind–body exercise interventions on psychological and physical outcomes in individuals with type 2 diabetes mellitus using a network meta-analysis. Methods: This study systematically searched PubMed, Embase, Web of Science, and the Cochrane Library, and conducted a frequentist network meta-analysis using Stata with SUCRA-based ranking; risk of bias was assessed using RoB 2.0, certainty of evidence evaluated with CINeMA, and robustness examined through sensitivity analyses and publication bias assessment using funnel plots. Results: This study provides preliminary, outcome-specific evidence based on 13 randomized controlled trials involving over 500 individuals with type 2 diabetes mellitus. Network meta-analysis suggested that Pilates significantly improved balance ability (SMD = 1.52, 95% CI 0.77–2.28) and walking ability (SMD = 1.20, 95% CI 0.28–2.12) compared with control. Walking Meditation showed a favorable effect on aerobic capacity (SMD = 1.40, 95% CI 0.44–2.37), while yoga improved muscle strength (SMD = 0.79, 95% CI 0.26–1.33). Mindfulness-based interventions were associated with reduced anxiety (SMD = 1.05, 95% CI 0.46–1.63). Sensitivity analyses indicated that physical function outcomes were generally robust, whereas psychological outcomes were sensitive to influential studies. The certainty of evidence was predominantly very low according to CINeMA assessment. Conclusion: This network meta-analysis provides preliminary, outcome-specific evidence that mind–body exercise may improve physical function in type 2 diabetes, while effects on psychological outcomes remain uncertain and warrant further high-quality research.
Keywords: mind–body exercise, Network meta-analysis, pilates, Qigong, Tai Chi, type 2 diabetes mellitus, Yoga
Received: 19 Nov 2025; Accepted: 13 Feb 2026.
Copyright: © 2026 Wu, Yuan and Gao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Fuwei Wu
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