Comparative Effects of Aerobic vs. Resistance Training on Glycemic Control and Joint Pain in Diabetic Patients

Abstract

Background: Type 2 diabetes mellitus is frequently accompanied by poor glycemic control and musculoskeletal pain, both of which impair functional capacity and adherence to healthy lifestyle behaviors. Exercise therapy is known to improve metabolic outcomes, but limited evidence directly compares aerobic and resistance training within the same trial while concurrently evaluating joint pain. Objective: To compare the effects of aerobic versus resistance training, relative to usual care, on glycemic control, lipid profile, physical activity, and joint pain in adults with type 2 diabetes. Methods: A three-arm randomized controlled trial was conducted over 12 weeks in Multan, enrolling 90 adults with type 2 diabetes allocated to aerobic training, resistance training, or usual care. Participants in the exercise groups completed supervised sessions three times weekly. Outcomes included HbA1c, fasting and postprandial glucose, lipid profile, BMI, waist circumference, physical activity, and joint pain. Repeated-measures ANOVA and multivariable regression assessed intervention effects. Results: Both aerobic and resistance training significantly improved HbA1c (−1.2% and −1.0% vs −0.1%), fasting glucose, lipids, and joint pain (−2.6 and −3.1 vs −0.1 NPRS) compared with controls (p<0.001). Aerobic training showed slightly superior glycemic improvement, while resistance training provided greater pain reduction. Conclusion: Structured aerobic and resistance training are effective adjunct therapies for improving metabolic and musculoskeletal outcomes in adults with type 2 diabetes.