Nutr Rev. 2026 Mar 24:nuag010. doi: 10.1093/nutrit/nuag010. Online ahead of print.
ABSTRACT
CONTEXT: Type 2 diabetes mellitus (T2DM) is a common chronic metabolic disorder frequently linked to unhealthy dietary habits and sedentary behavior. Overweight and obesity are major risk factors for T2DM, which increases the risk of cardiovascular diseases. While exercise interventions are an effective strategy in the management of diabetes mellitus and its complications, vitamin D supplementation has also shown potential to enhance insulin sensitivity and reduce inflammation in patients with T2DM. Recent studies have indicated that combining exercise with vitamin D supplementation may overcome the limitations of single interventions, yielding significant synergistic effects in managing T2DM.
OBJECTIVE: In this study we conducted a meta-analysis and systematic review to examine the effects of exercise combined with vitamin D supplementation on glycemic control, body mass index (BMI), and lipid profiles in patients with T2DM and to explore the optimal dosage and duration of combined interventions, offering evidence-based guidance for clinical practice.
DATA SOURCES: A systematic search of 8 databases (PubMed, Cochrane Library, Web of Science, Embase, CNKI, CBM, VIP, and WanFang) was conducted to identify randomized controlled trials published up to March 12, 2024.
DATA EXTRACTION: In this study we evaluated the effects of exercise training (Ex) and vitamin D supplementation (VD) separately or their combination (Ex-VD) on glycemic control, lipid profiles, and BMI in patients with T2DM through randomized controlled trials. The outcomes include glycosylated hemoglobin (HbA1c), fasting blood glucose (FBG), total cholesterol (TC), triglycerides (TGs), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and BMI.
DATA ANALYSIS: The meta-analysis results indicated that, compared to the control group, the Ex-VD group had significantly reduced BMI (P < .01), HbA1c (P = .01), FBG (P < .01), TC (P < .01), TG (P < .01), LDL (P < .01), and HDL (P = .02) levels in patients with T2DM. Subgroup analysis of different doses of vitamin D supplementation combined with exercise showed that supplementation of >2000 IU/d significantly improved blood glucose, BMI, TC, TG, and LDL levels. Subgroup analysis comparing combined and single interventions indicated that the Ex-VD group had a greater effect on HbA1c, FBG, TC, and TG compared to single intervention alone.
CONCLUSION: The integrated intervention of exercise and vitamin D supplementation demonstrates significant efficacy in improving glycemic control, lipid profiles, and BMI among patients with T2DM. Notably, the combined approach yields greater improvements in glycosylated hemoglobin, FBG, HDL, LDL, TG, and TC compared to either intervention alone. Based on these findings, clinical guidelines for T2DM management should incorporate an 8- to 12-week structured exercise regimen (equivalent to 900-1026 metabolic equivalent of task [MET]-min/wk) complemented by daily vitamin D supplementation exceeding 2000 IU.
SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration No. CRD42023445462. Available from: https://www.crd.york.ac.uk/prospero/display_record.php? ID=CRD42023445462.
PMID:41874282 | DOI:10.1093/nutrit/nuag010