Table 1. Characteristics of the included studies according to population, intervention, comparator, and outcomes.
Study C P N
(AE/RT)		 Weeks Age (yrs) BMI (kg/m2) Intervention
(AE)		 Comparator
(RT)		 Primary
outcomes		 Dropout (%) (AE/RT)
Ranasinghe
et al., 2021		 Sri Lanka Adults with
diabesity		 28 / 28 12 ~50 NR 60-75% HRmax, walking/
cycling/stepper, 60-75 min, 2×/wk		 50-60% 1RM, 7 exercises, 3×8 reps, 2×/wk;
supervised		 BW, BF, WC, FBG, FI, HbA1c, SBP, DBP 26 / 26
Bacchi
et al., 2012		 Italy Adults with
diabesity		 19 / 19 16 40-70 ~29 cycling 60% VO2max, 60 min, 3×/wk 70-80% 1RM, 9 exercises,
progressive, 3×/wk;
supervised		 BMI, WC, FBG, HbA1c, HDL, LDL, TC, TG, SBP, DBP, CRF 5 / 5
Cauza
et al., 2005		 Austria Adults with
diabesity		 17 / 22 16 ~58-60 ~31-34 ~60-80% VO2peak, 3×/wk ~70-80% 1RM, 3×/wk BW, BF, FFM, FBG, FI, HbA1c, HDL, LDL, TC, TG, SBP, DBP, CRF 14 / 13
Church
et al., 2010		 USA Adults with
diabesity		 72 / 73 36 NR ~35 12 kcal/kg/wk, 50-80% VO2max, 3×/wk 7 machine exercises, progressive, 3×/wk BMI, HbA1c 4 / 7
Jorge
et al., 2011		 Brazil Adults with
diabesity		 12 / 12 12 ~54 ~29-32 cycling at lactate threshold, 60 min, 3×/wk 60-80% 1RM, 8 exercises, circuit, 3×/wk BMI, WHR, FBG, HbA1c, HOMA-IR, HDL, TC, TG, CRF 0 / 0
Kadoglou et al., 2013 Greece Adults with
diabesity		 21 / 23 24 AE
58 ± 5
RT
56 ± 5		 AE
32 ± 3
RT
33 ± 3		 60-75% HRmax, 60 min, 4×/wk 60-80% 1RM,
supervised		 BF, WHR, FBG, FI, HOMA-IR, HbA1c, HDL, LDL, TC, TG, SBP, DBP, CRF 16 / 8
Ku et al., 2010 South Korea Adults with
diabesity		 15 / 13 12 NR NR walking 60 min, 3.6-5.2 METs, 5×/wk elastic band, 40-50% max, 5×/wk BW, BMI, WHR, FBG, HbA1c 0 / 0
Moe et al., 2011 Norway Adults with
diabesity		 13 / 13 12 ~56-58 ~29-31 75-85% VO2peak, 3×/wk ~60% 1RM, 3×/wk BMI, FBG, HbA1c, HC, WC, WHR, SBP, DBP, CRF 0 / 0
Ng et al., 2010 Singapore Adults with
diabesity		 30 / 30 8 58 ± 7 28 ± 5 similar
volume
aerobic
exercise;
8 wk		 progressive resistance training of similar
volume; 8 wk		 BW, BF, BMI, FBG, HbA1c, WC, WHR, SBP, DBP 20 / 17
Shenoy et al., 2009 India Adults with
diabesity		 10 / 10 16 NR ~26-27 moderate
intensity, 3×/wk		 60↓100% 1RM
progressive, 2×/wk		 BMI, FBG, HbA1c, SBP, DBP 0 / 0
Sigal et al., 2007 Canada Adults with
diabesity		 60 / 64 22 NR ~34-36 treadmill/
cycling, 60-75% HRmax, 3×/wk		 8-9RM
progressive, 3×/wk		 BW, BF, FFM, BMI, WC, HbA1c, HDL, LDL, TC, TG, SBP, DBP 0 / 0
Yavari et al., 2012 Iran Adults with
diabesity		 15 / 15 52 51 ± 9 NR 60↓75% HRmax, 20↓60 min, 3×/wk 60↓80% 1RM, 10
exercises, 3×8-10 reps, 3×/wk		 BW, BF, FBG, HbA1c, HDL, LDL, TC, TG, SBP, DBP, RHR, CRF 25 / 25
Kobayashi et al., 2023 Japan Adults with
diabesity		 63 / 61 36 ~60 NR moderate-to-vigorous
target HR zone, 3×/wk		 8-12RM progressive, 3×/wk BF, FFM, FBG, HbA1c 28 / 27
Duan and Lu, 2024 China Adults with
diabesity		 12 / 12 12 40-45 ≥ 30 60-75% HRR, 4×/wk 60-80% 1RM, 3×/wk FBG, FI, HOMA-IR, HbA1c, HDL, LDL, TC, TG, CRF 0 / 0
Shahzadi et al., 2025 Pakistan Adults with
diabesity		 20 / 20 12 ~50-55 NR ~60-70% HRmax, 3×/wk ~60-70% 1RM, 3×/wk HbA1c, CRF 9 / 4
Piralaiy et al., 2025 Thailand Adults with
diabesity		 11 / 11 12 ~50-55 NR ~60-70% HRR,
3×/wk		 ~60-70% 1RM, 3×/wk BMI 15 / 15
Kwon et al., 2011 South Korea Adults with
diabesity		 13 / 12 12 57 ± 7 27 ± 2.3 walking 60 min, 3.6-6.0 METs, 5
×/wk		 bands,
3×10-15,
progressive, 3×/wk		 BW, FBG, HbA1c, HDL, LDL, TC, TG, SBP, DBP, CRF 0 /0
Sukala et al., 2012 New
Zealand		 Adults with
diabesity		 9 / 9 16 49 ± 5 44 ± 10 supervised, 3×/wk,
16 wk		 supervised, 3×/wk,
16 wk		 BW, BF, BMI, WC, FBG, FI, HbA1c, HDL, LDL, TC, TG, SBP, DBP 31 / 31
Elsayed et al., 2024 Egypt Adults with
diabesity		 20 / 20 12 ~mid-50s ≥ 25 ~60-70% HRmax, 3×/wk ~60-70% 1RM, 3×/wk FI, TC 0 / 0
Arora et al., 2009 India Adults with
diabesity		 10 / 9 8 NR NR walking 30 min, 3×/wk 60↓100% 1RM, 7
exercises, 3×10, 2×/wk		 BMI, HbA1c,
HDL, TC, TG,
SBP, DBP, RHR		 0 / 10
Oliveira et al., 2012 Brazil Adults with
diabesity		 11 / 10 12 AT
52 ± 9
RT
54 ± 9		 AT
29 ± 2
RT
31 ± 4		 cycling at lactate threshold,
progressed to 50 min, 3×/wk		 circuit 7
exercises, 4×8-12 to failure, 3×/wk		 BW, BF, WC, WHR, FBG, HbA1c, HDL,
LDL, TC, TG, SBP, DBP, CRF		 0 / 0
Swift et al., 2012 USA Adults with
diabesity		 50 / 58 ~36 AE
56 ± 8
RT
59 ± 8		 AE
34 ± 6
RT
34 ± 5		 12 kcal/kg/wk (HART-D) 3×/wk, 2-3 sets, 10-12 reps, progressive BF, FFM,
FBG, HbA1c, WC, CRF		 8 / 5
Reid et
al., 2010		 Canada Adults with
diabesity		 51 / 58 22 39-70 AE
34 ± 6 RT
33 ± 6		 treadmill/cycling to 45 min at 75% HRmax, 3×/wk 8 machine
exercises, 2-3 sets, ~8RM, 3×/wk		 BMI, RHR 0 / 0
C: country, P: Population, AE: Aerobic exercise, RT: Resistance training, BMI: Body mass index, BW: Body weight, BF: Body fat, WC: Waist circumference, WHR: Waist-to-hip ratio, FBG: Fasting blood glucose, FI: Fasting insulin, HbA1c: Glycated hemoglobin, HOMA-IR: Homeostatic model assessment of insulin resistance, HDL=High-density lipoprotein cholesterol, LDL: Low-density lipoprotein cholesterol, TC: Total cholesterol, TG: Triglycerides, SBP: Systolic blood pressure, DBP: Diastolic blood pressure, CRF: Cardiorespiratory fitness.