Diabetes & Metabolic Syndrome-Clinical Research & Reviews最新文献

{"title":"Abdominal obesity (Waist Circumference/Waist Circumference-to-Height Ratio) as a new vital sign in Asian Indians: The most dangerous fat we rarely measure","authors":"Amerta Ghosh , Anoop Misra","doi":"10.1016/j.dsx.2026.103389","DOIUrl":"10.1016/j.dsx.2026.103389","url":null,"abstract":"","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 3","pages":"Article 103389"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147358487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of early life exposure to active play and movement on health and wellbeing across the lifespan: A narrative review of RCTs from 2020-2025","authors":"Andrew P. Hills ,&nbsp;Fadiah Alkhattabi ,&nbsp;Reem Alahmed ,&nbsp;Saleh Ali Alessy ,&nbsp;Sisitha Jayasinghe ,&nbsp;Sadeem Aldarwesh ,&nbsp;Rowaedh A. Bawaked ,&nbsp;Lama Abdulla ,&nbsp;Sawsan Albalawi ,&nbsp;Afaf Alsagheir ,&nbsp;Ghadi Alaskar ,&nbsp;Severin Rakic ,&nbsp;Predrag Zivotic ,&nbsp;Volkan Cetinkaya ,&nbsp;Saleh A. Alqahtani","doi":"10.1016/j.dsx.2026.103399","DOIUrl":"10.1016/j.dsx.2026.103399","url":null,"abstract":"<div><h3>Introduction/background</h3><div>Competence in fundamental movement skills (FMS) is associated with higher physical activity levels across childhood and adolescence, influencing lifelong movement behaviours. Despite these benefits, most children globally fail to meet recommended physical activity levels from an early age and are increasingly affected by unhealthy body composition and chronic conditions such as obesity and type 2 diabetes (T2D). This article synthesises current evidence on early-life movement behaviours and interventions promoting physical activity during the first 2000 days, a critical developmental period shaping long-term health.</div></div><div><h3>Materials and methods</h3><div>A comprehensive search of peer-reviewed randomized controlled trials (RCTs) published between 2020 and 2025 in Medline and Scopus identified studies examining physical activity, motor skill development, and related health outcomes in children aged 0-5 years. Findings were organized into five themes: (1) movement behaviours and early health; (2) historical development of guidelines; (3) global consensus and gaps; (4) early-years interventions; and (5) emerging implications.</div></div><div><h3>Results</h3><div>Eighteen studies met inclusion criteria. Evidence highlighted the importance of physical activity, adequate rest, and limited sedentary behaviour for early development. Most studies focused on preschoolers, with fewer addressing infants and toddlers. Interventions were largely from high-income contexts and varied in design and measurement tools. Integrating physical literacy showed promise.</div></div><div><h3>Discussion</h3><div>Early movement experiences shape body composition and chronic disease risk. Focusing on the first and next 1000 days may foster lifelong healthy habits. Future work should enhance equity, diversity, and measurement consistency in interventions.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 3","pages":"Article 103399"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147451133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of alpha lipoic acid supplementation on biochemical, clinical, and inflammatory parameters in patients with diabetic polyneuropathy: A systematic review and meta-analysis","authors":"Ayline Vergara Salinas ,&nbsp;Trinidad Meneses Caroca ,&nbsp;Fernanda Peña Santibáñez ,&nbsp;Javiera Rojo González ,&nbsp;Michelle López-Chaparro ,&nbsp;Marisol Barahona-Vásquez ,&nbsp;Jessica Paola Loaiza-Giraldo ,&nbsp;Consuelo Gómez-Valdovinos ,&nbsp;Juan José Valenzuela-Fuenzalida ,&nbsp;Pablo Nova-Baeza ,&nbsp;Mathias Orellana-Donoso ,&nbsp;Alejandro Bruna-Mejias ,&nbsp;Gloria Cifuentes-Suazo ,&nbsp;Gustavo Oyanedel-Amaro ,&nbsp;Juan Sanchis-Gimeno ,&nbsp;Guinevere Granite ,&nbsp;Felipe Araya-Quintanilla","doi":"10.1016/j.dsx.2026.103374","DOIUrl":"10.1016/j.dsx.2026.103374","url":null,"abstract":"<div><h3>Introduction</h3><div>In this article, we perform a systematic review and meta-analysis evaluating the effects of alpha-lipoic acid (ALA) supplementation on biochemical, clinical, inflammatory, and functional parameters in patients with diabetic polyneuropathy or diabetic peripheral neuropathy (DPN). A total of 15 articles were included, of which 12 were analyzed for outcomes. DPN is a chronic complication of Diabetes Mellitus (DM) characterized by symptoms, such as pain, sensory disturbances, and reduced quality of life. Currently, there is no definitive cure. Management focuses on controlling blood glucose and alleviating symptoms through pharmacological and non-pharmacological therapies. The aim of this study is to analyze the evidence regarding the efficacy of alpha-lipoic acid (ALA) supplementation in the management of DPN.</div></div><div><h3>Results</h3><div>A systematic search across multiple databases was conducted using keywords, such as “diabetes mellitus,” “diabetes mellitus type I,” “diabetes mellitus type II,” “alpha-lipoic acid,” and “ALA supplementation.” A total of 15 studies met the inclusion criteria. Of the 23 outcomes analyzed, 19 showed significant differences in favor of alpha-lipoic acid (ALA) supplementation at different doses versus a placebo or other treatments. Notable improvements were observed in Total Symptom Score (TSS) paresthesia (SMD = −1.04; 95 % CI = −1.24 to −0.84; p &lt; 0.00001), TSS numbness (SMD = −0.23; 95 % CI = −0.44 to −0.01; p = 0.04), and the Hamburg Pain Adjective List (HPAL) (SMD = −1.00; 95 % CI = −1.15 to −0.85; p &lt; 0.00001), among others. These improvements were particularly evident for symptoms, such as paresthesia, numbness, and burning sensations, especially at a dose of 600 mg/day. In contrast, four of the outcomes HbA1c, nitric oxide levels, sural sensory nerve action potential, and peroneal motor nerve conduction velocity showed no significant changes.</div></div><div><h3>Conclusion</h3><div>The evidence suggests that ALA, especially at 600 mg/day, is a safe and potentially effective adjunct therapy for symptom management in DPN, although its impact on nerve conduction and long-term glycemic control remains inconclusive.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 2","pages":"Article 103374"},"PeriodicalIF":3.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146081425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of fibrosis-4 and NAFLD fibrosis score for screening liver fibrosis in Indian individuals with type 2 diabetes: a prospective cross-sectional study","authors":"Narendra Singh Choudhary ,&nbsp;Mohammad Shafi Kuchay ,&nbsp;Swapnil Dhampalwar ,&nbsp;Kunwar Ashish Singh ,&nbsp;Manish Kumar Singh ,&nbsp;Gargi Singh ,&nbsp;Neeraj Saraf ,&nbsp;Ajay Duseja","doi":"10.1016/j.dsx.2026.103380","DOIUrl":"10.1016/j.dsx.2026.103380","url":null,"abstract":"<div><h3>Background</h3><div>Blood-based non-invasive tests (NITs) in patients with T2DM/MASLD help in assessing the stage of hepatic fibrosis, but there is sparse data in the Indian population.</div></div><div><h3>Methods</h3><div>Fibrosis-4 (FIB-4) and NAFLD fibrosis score (NFS) were calculated for all individuals with T2DM with MASLD and compared to liver stiffness measurement (LSM) values obtained by vibration-controlled transient elastography (VCTE) with cut-offs of ≥9.7 kPa (rule-in cut-off for advanced fibrosis) and &lt;6 kPa (as a rule-out cut-off for significant fibrosis).</div></div><div><h3>Results</h3><div>The prospective study included 789 patients (238 females) with T2DM and MASLD, aged 53.3 ± 10.3 years. The LSM values were ≥9.7 in 102 (12.9%). Results for the whole group were as follows: The optimal rule-in cut-off for FIB-4 was 1.68 (AUROC 0.69, 95% CI 0.637–0.746, sensitivity 64.7%, specificity 65.2%). The optimal rule-in cut-off of NFS for advanced fibrosis was −0.389 (AUROC 0.619, 95% CI 0.560 to 0.678, sensitivity 61.8%, specificity 57.4%). Rule-out cut-offs also had poor AUROCs (0.586 for FIB-4 and 0.570 for NFS). The diagnostic accuracy of the earlier suggested rule-in (for advanced fibrosis) cut-offs of FIB-4 (&gt;2.67) was 81.3% (sensitivity 22.1%, specificity 92.2%). The diagnostic accuracy of NFS (&gt;0.675) for advanced fibrosis was 79.4% (sensitivity 21.3% and specificity 90.1%). The diagnostic accuracy of the rule-out cut-offs was 52.7% for FIB-4 (at value &lt; 1.3) and 53.8% for NFS (at value &lt; -1.455).</div></div><div><h3>Conclusion</h3><div>The performance of FIB-4 and NFS to predict or rule out advanced fibrosis was poor in Indian patients with type 2 diabetes mellitus and MASLD.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 2","pages":"Article 103380"},"PeriodicalIF":3.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global assessment of insulin and oral hypoglycaemic agent accessibility and affordability: A cross-sectional survey of international diabetes federation member countries","authors":"Bishwajit Bhowmik ,&nbsp;Tasnima Siddiquee ,&nbsp;Nayla Cdv. Moreira ,&nbsp;Amit Gupta ,&nbsp;Banshi Saboo ,&nbsp;A.K.A. Khan ,&nbsp;Sameer Pathan ,&nbsp;Phil Riley ,&nbsp;Abhimanyu S. Chauhan","doi":"10.1016/j.dsx.2026.103378","DOIUrl":"10.1016/j.dsx.2026.103378","url":null,"abstract":"<div><h3>Aims</h3><div>To examine global stakeholder perspectives on the availability, affordability, and access barriers to insulin and oral hypoglycaemic agents (OHAs), based on a cross-sectional survey of International Diabetes Federation (IDF) member associations.</div></div><div><h3>Methods</h3><div>A mixed-methods online survey was conducted among designated informants from 86 IDF member associations across 131 responses. The questionnaire covered medicine availability, reimbursement mechanisms, affordability, and access constraints. Quantitative data were analysed descriptively, and open-ended responses were thematically analysed. In cases of multiple responses from the same country, all were included to capture diverse perspectives.</div></div><div><h3>Results</h3><div>Insulin analogues were reported as available in 68.8% of settings, with full reimbursement in 63.5%. Biguanides and sulfonylureas were the most available OHAs. Major access barriers included high out-of-pocket costs, limited insurance coverage, supply disruptions, and insufficient patient education. Regional representation was uneven, with over-representation from South and Central America and under-representation from South-East Asia; thus, subgroup comparisons should be interpreted with caution.</div></div><div><h3>Conclusions</h3><div>Substantial perceived disparities in access to diabetes medicines persist across countries, particularly in low- and lower-middle-income settings. These findings reinforce the urgent need for improved financing, strengthened supply chains, and integrated patient-centred strategies. This study contributes to the global evidence base by providing a contemporary, policy-relevant snapshot of diabetes medicine access challenges in 2024–2025, supporting national and international efforts to close equity gaps.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 2","pages":"Article 103378"},"PeriodicalIF":3.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Highlights of the current issue","authors":"Ningjian Wang ,&nbsp;Anoop Misra","doi":"10.1016/j.dsx.2026.103390","DOIUrl":"10.1016/j.dsx.2026.103390","url":null,"abstract":"","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 2","pages":"Article 103390"},"PeriodicalIF":3.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147422264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of the performance of non-invasive risk models to predict incident type 2 diabetes in a Swedish population – Västerbotten Intervention Programme","authors":"Melony Fortuin-de Smidt ,&nbsp;Olov Rolandsson ,&nbsp;Simon J. Griffin ,&nbsp;Patrik Wennberg","doi":"10.1016/j.dsx.2026.103379","DOIUrl":"10.1016/j.dsx.2026.103379","url":null,"abstract":"<div><h3>Aim</h3><div>We assessed the performance of non-invasive risk prediction models to predict 10-year incident type 2 diabetes in a large Swedish cohort.</div></div><div><h3>Methods</h3><div>Using the Västerbotten Intervention Programme (VIP) cohort, which includes serial oral glucose tolerance tests (OGTTs), we assessed discrimination (concordance (c)-statistic) and calibration (expected-to-observed probability ratio, integrated calibration index, calibration slope and plots) before and after recalibration in twelve non-invasive models. Incident diabetes cases were determined by an OGTT at a 10-year follow-up visit or through previously validated register-based cases.</div></div><div><h3>Results</h3><div>Among 91708 VIP participants, the 10-year diabetes incidence was 2.8 %. Most models had acceptable discrimination (c-statistic ≥0.70 and &lt; 0.80). Discrimination was better in women and persons &lt;50 years old. Eight models overestimated and four models underestimated mean absolute risk. Recalibration improved miscalibration in all models. Overall, the Framingham Personal and QDScore models’ predictions were most accurate but the Framingham model included more easily obtainable variables. Most models overestimated risk in older people while no consistent pattern was observed across sexes.</div></div><div><h3>Conclusion</h3><div>All models required recalibration to improve prediction accuracy. The Framingham personal model is recommended for risk predictions and will be the easiest to implement.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 2","pages":"Article 103379"},"PeriodicalIF":3.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146133941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prevalence of cardiometabolic and renal long-term conditions in individuals with type 2 diabetes mellitus: a global umbrella review","authors":"Sarah Hassen ,&nbsp;Cameron Razieh ,&nbsp;Lauren O'Mahoney ,&nbsp;Thomas J. Wilkinson ,&nbsp;Aleksandra Gawlik-Lipinski ,&nbsp;Shukrat O. Salisu-Olatunji ,&nbsp;Elizabeth Hickman ,&nbsp;Monica Kundu ,&nbsp;Kamlesh Khunti ,&nbsp;Clare L. Gillies","doi":"10.1016/j.dsx.2026.103381","DOIUrl":"10.1016/j.dsx.2026.103381","url":null,"abstract":"<div><h3>Background and aims</h3><div>There is a high prevalence of long-term conditions (LTCs) among people with type 2 diabetes (T2D). This umbrella review synthesises and collates the existing evidence.</div></div><div><h3>Methods</h3><div>This review was registered in PROSPERO (CRD42024490470) and follows the Joanna Briggs Institute guidelines (JBI) for umbrella reviews. Comprehensive searches of Ovid Medline, Ovid Embase, Cochrane, and CINAHL databases were conducted. Systematic reviews of observational studies on cardiometabolic and renal LTCs in T2D were included. Quality was assessed using the JBI Critical Appraisal Checklist for systematic reviews, and study results were narratively synthesised.</div></div><div><h3>Results</h3><div>Out of 10,721 records, 20 systematic reviews (15 with meta-analyses) were included, comprising 675 primary studies. The most commonly reported cardiometabolic condition in T2D was cardiovascular disease, with a pooled prevalence ranging from 13·0% (95% CI: 11·0,15·0) to 46·0% (39·0, 54·0), followed by heart failure with the highest pooled prevalence reported as 25·0% (21·0, 28·0). For renal conditions in T2D, the overall pooled prevalence for nephropathy ranged from 4·2% (3·2, 5·3) to 38·0% (14·0, 63·0), while chronic kidney disease reported prevalence ranged from 18·2% (15·1, 21·4) to 35·5% (25·9, 45·5). The prevalence of these conditions varied by sex and income status, with higher rates observed in males and low-income and middle-income countries.</div></div><div><h3>Conclusion</h3><div>This review highlights the significant prevalence of cardiometabolic and renal LTCs in T2D, highlighting the need for targeted and holistic management approaches to address these comorbidities effectively.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 2","pages":"Article 103381"},"PeriodicalIF":3.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146133963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of glucose monitoring devices on relationships with food and eating behaviour for people with type 2 diabetes mellitus: A review of the literature","authors":"S. Mackie ,&nbsp;T. Wallace ,&nbsp;J. Heath","doi":"10.1016/j.dsx.2026.103376","DOIUrl":"10.1016/j.dsx.2026.103376","url":null,"abstract":"<div><h3>Background</h3><div>There is limited understanding of the impact of glucose monitoring technologies on relationships with food and eating behaviours for those with type 2 diabetes mellitus (T2DM).</div></div><div><h3>Aims</h3><div>With previous reviews focused on T2DM treatment burden and self-management, this review aims to enhance understanding of the impact of flash or continuous glucose monitoring (FGM/CGM) on users’ eating behaviours and relationships with food as this can inform important recommendations for CGM use amongst those with T2DM.</div></div><div><h3>Method</h3><div>A systematic search was conducted across four databases: Scopus, Medline, CINAHL and PubMed, from October-November 2024, following PRISMA guidelines. Studies were quality appraised and qualitative data was synthesized using thematic synthesis.</div></div><div><h3>Findings</h3><div>Thirteen studies met inclusion criteria and their findings were included in the synthesis. The review revealed that F/CGM enhanced participants’ nutritional awareness, supported personalised dietary experimentation, and fostered intentional eating behaviours. However, data overload and emotional burden were also reported, with some users experiencing restrictive or distressing impacts on their relationship with food. These insights inform practical recommendations for CGM implementation with those with T2DM.</div></div><div><h3>Conclusion</h3><div>Further research should aim to identify factors that contribute to successful adaptation to CGM and explore the long-term effects of CGM use on food relationships.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 2","pages":"Article 103376"},"PeriodicalIF":3.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146260554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-weight-bearing lower-limb simple resistance activities, soleus push-ups, and muscle stretching: Impact on glycemic control and metabolic–circulatory outcomes","authors":"Raju Vaishya ,&nbsp;Abhishek Vaish ,&nbsp;Patinharayil Gopinathan ,&nbsp;Anoop Misra","doi":"10.1016/j.dsx.2026.103375","DOIUrl":"10.1016/j.dsx.2026.103375","url":null,"abstract":"<div><h3>Objective</h3><div>To review the role of lower-body skeletal muscle non-weight-bearing simple resistance activities (SRAs), soleus push-ups (SPUs), and stretching exercises (SEs) in improving glycemic control and metabolic/circulatory outcomes in those individuals who cannot do weight-bearing aerobic exercises due to musculoskeletal, cardiorespiratory and other reasons.</div></div><div><h3>Research design and methods</h3><div>We conducted a narrative review of randomized controlled trials, prospective cohorts, and pilot interventions identified through searches of PubMed/MEDLINE, Scopus, Web of Science, Cochrane Library, EBSCO, and ScienceDirect. We examined non-weight-bearing SRAs, SPUs, and SEs, focusing on pathophysiological mechanisms and clinical outcomes.</div></div><div><h3>Results</h3><div>Moderate lower-body strength is associated with 32–35% lower type 2 diabetes (T2D) risk (HR: 0.68, 95% CI: 0.49–0.94). Interrupting prolonged sitting with 3-min SRAs every 30 min reduces insulin response by 26%. SPUs—sustained, seated plantarflexion contractions—reduce postprandial glucose by 39–52% and insulin response by 60% during oral glucose tolerance tests. Passive SE for 40 min acutely lowered blood glucose by 24–28 mg/dL, chronically improves femoral blood flow by 30% and flow-mediated dilation by 25%. Benefits are likely mediated through AMPK-dependent GLUT4 translocation, myokine secretion, and improved endothelial function.</div></div><div><h3>Conclusions</h3><div>Lower-body SRAs, SPUs, and SEs are simple interventions that can be performed while seated and have the potential to significantly improve glucose regulation, insulin sensitivity, and vascular function in populations unable to engage in traditional weight-bearing aerobic exercise. Integration into clinical practice could provide cost-effective tools for the prevention and management of T2D. Finally, the effects of these exercises should be evaluated in long-term studies to determine their impact on glycaemic control and cardiovascular protection.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 2","pages":"Article 103375"},"PeriodicalIF":3.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146160089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}