Both Traditional Chinese Exercise and Kuanle Equipment Exercise improved glycaemic outcomes and increased serum 25(OH)D3 compared with usual care in middle-aged and elderly adults with prediabetes, though the superiority of KEE over TCE was not established.
Both exercise interventions significantly improved fasting plasma glucose compared to usual care after 12 weeks.
Both exercise interventions significantly improved 2-hour OGTT glucose compared to usual care.
Both exercise interventions significantly reduced HbA1c compared to usual care.
Both exercise interventions substantially increased serum 25(OH)D3 compared to usual care.
Change in serum 25(OH)D3 was inversely associated with change in 2-hour OGTT glucose in an exploratory analysis.
Participants in the trial had vitamin D deficiency at baseline.
KEE produced numerically larger estimates than TCE across all primary glycaemic and vitamin D outcomes, but superiority was not statistically established.
This research suggests that both Traditional Chinese Exercise (a category including practices like Tai Chi and Qigong) and Kuanle Equipment Exercise (a community-based equipment exercise program) can meaningfully improve blood sugar control in middle-aged and older adults who have prediabetes — a condition where blood sugar is elevated but not yet at diabetic levels. After 12 weeks, participants in both exercise groups saw significant reductions in fasting blood glucose, post-meal blood glucose (measured via an oral glucose tolerance test), and HbA1c (a measure of average blood sugar over several months), compared to a control group receiving usual care. The improvements were clinically notable, with reductions ranging from roughly 7% to 21% depending on the measure and exercise type. A surprising additional finding was that both exercise groups also showed large increases in vitamin D levels — rising by about 61% in the Traditional Chinese Exercise group and 82% in the equipment exercise group. Since baseline vitamin D levels were quite low (in the deficiency range) for all participants, this increase may be partly explained by outdoor exercise increasing sun exposure. An exploratory analysis found that greater increases in vitamin D were linked to greater reductions in post-meal blood sugar, though this relationship did not hold for other blood sugar measures. The authors caution that future studies need to carefully measure sunlight exposure and dietary vitamin D intake to properly understand this relationship. While the equipment-based exercise group showed numerically larger improvements across all measures, the differences between the two exercise groups were not statistically significant, meaning neither approach was proven superior to the other. This research suggests that both exercise types may be practical, accessible options for helping prevent progression from prediabetes to type 2 diabetes in older adults, though larger trials are needed to confirm these findings and better understand the role of vitamin D.
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Upload Your LabsLingzhi X, Chunhua Z, Wu L, Jiejin D, Yimin Y. (2026). Comparison of Traditional Chinese Exercise and Equipment-Based Exercise on Glycaemic Control and Vitamin D Levels in Middle-Aged and Elderly Patients With Prediabetes: A Randomised Controlled Trial.. Endocrinology, diabetes & metabolism. https://doi.org/10.1002/edm2.70326