Effectiveness of community-based Baduanjin combined with resistance training on cardiometabolic risk factors in older adults with type 2 diabetes: a 16-week randomized controlled trial.

The short version

This randomized controlled trial with 123 older adults who have type 2 diabetes explored whether a community exercise program built from Baduanjin and resistance training could improve blood sugar and related health markers over 16 weeks. Baduanjin, also called the Eight-Section Brocades, is a traditional Chinese Qigong practice made of eight gentle postures linked with controlled breathing and meditation, and it places low demands on the body. Resistance training means working muscles against a load, here elastic bands. Older adults with diabetes face a high risk of complications and muscle loss, and conventional gym exercise can be hard to keep up, so the authors tested a low-impact alternative. Participants were aged 60 or older (average about 65), lived in eight communities in Shanghai, and were randomly assigned to the exercise group (60 people) or a comparison group (63 people). The exercise group attended supervised 60-minute sessions two to three times a week, each including 24 minutes of Baduanjin and 24 minutes of elastic-band exercises, with health checks before each session. The comparison group kept their usual routine, received standard diabetes care, and attended a health talk every four weeks. Blood tests, body composition, grip strength and blood pressure were measured before and after. Average HbA1c, a three-month marker of blood sugar, fell from 7.19% to 6.94% in the exercise group, while it rose from 6.94% to 7.08% in the comparison group (a between-group difference of 0.39 percentage points, p = 0.003). Fasting glucose dropped by an extra 0.81 mmol/L (p = 0.010). Body weight, body mass index and waist circumference fell more in the exercise group, and grip strength rose in both hands (left +2.02, right +3.75, both p < 0.001). Blood pressure and cholesterol measures did not change differently between groups. Within the exercise group weight fell by 1.99 kg (p < 0.001), whereas the comparison group showed no significant within-group change in body composition, blood sugar or lipid measures. Hip circumference also did not differ between groups (p = 0.097). No exercise-related adverse events were reported, and attendance averaged 90.6%. The authors suggest the program is feasible in community settings and may improve selected cardiometabolic markers, but the evidence has limits. Follow-up lasted only four months, all participants came from one district, the trainer could not be blinded, education levels differed between groups, and the design cannot show how much each component contributed. The authors attribute the benefits to mechanisms such as greater muscle glucose uptake and less abdominal fat, although these were not measured in the trial.

Key findings

• In a 16-week randomized trial of 123 community-dwelling adults aged 60 and over with type 2 diabetes, a program of Baduanjin (a traditional Chinese Qigong routine of eight gentle movements) plus elastic-band resistance training lowered HbA1c (a three-month blood sugar marker) by an extra 0.39 percentage points compared with routine care (p = 0.003).
• Fasting plasma glucose also fell by an additional 0.81 mmol/L (p = 0.010), and body weight, BMI and waist circumference decreased more in the exercise group than in the comparison group.
• Handgrip strength (a simple measure of muscle strength) rose more in the exercise group, by 2.02 on the left and 3.75 on the right (both p < 0.001), but blood pressure and cholesterol measures did not change differently between the groups.
• No exercise-related adverse events were reported and attendance averaged 90.6%, but the trial lasted only 4 months in one Shanghai district, and it cannot separate the effect of Baduanjin from that of resistance training.

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