Effects of elastic-band resistance training on glycemic control, muscle strength, and functional outcomes in patients with type 2 diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials.

Patients with type 2 diabetes mellitus (T2DM) commonly experience reduced muscle strength and impaired physical function, which may complicate long-term disease management. Elastic-band resistance training is inexpensive, portable, and suitable for home-based exercise; however, evidence regarding its effects on glycemic control, muscle strength, physical function, and muscle mass has not been comprehensively synthesized. This systematic review and meta-analysis evaluated the effects of elastic-band resistance training on these outcomes in adults with T2DM. PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Data, and VIP Database were searched from inception to June 5, 2026 for randomized controlled trials (RCTs) in adults with T2DM. Intervention effects were summarized using mean differences (MDs) or standardized mean differences (SMDs), and certainty of evidence was assessed using GRADE. Fourteen RCTs involving 684 participants were included. Elastic-band resistance training was associated with reductions in HbA1c (MD = -0.41, 95% CI -0.62 to -0.20) and fasting plasma glucose (FPG; MD = -0.79, 95% CI -1.01 to -0.56), with moderate-certainty evidence for both outcomes. Leave-one-out sensitivity analyses yielded consistent results, supporting the robustness of the primary findings. Handgrip strength also improved (MD = 2.67, 95% CI 1.07 to 4.26; I2 = 0%), with moderate-certainty evidence. Muscle-mass outcomes favored elastic-band resistance training (SMD = 0.24), although the confidence interval approached the null value and the certainty of evidence was low. Walking ability and sit-to-stand performance also showed favorable trends; however, substantial heterogeneity reduced confidence in these estimates. Adverse events were inconsistently reported, precluding firm conclusions regarding intervention safety. Elastic-band resistance training may improve glycemic control and muscle strength in adults with T2DM, whereas its effects on walking ability, sit-to-stand performance, and muscle mass remain uncertain. Given its low cost, portability, and suitability for home-based exercise, it may represent a practical adjunct to comprehensive exercise management, particularly for individuals with limited access to conventional resistance-training equipment. Safety remains insufficiently characterized because adverse-event reporting was incomplete. Further high-quality randomized controlled trials are warranted to strengthen the evidence base and refine optimal training prescriptions. www.crd.york.ac.uk/prospero, CRD420261417541.