Effects of Aquatic Exercise on Type 2 Diabetes Management in Adulthood: A Systematic Review and Meta-Analysis, Including Evidence on the Use of Wearable Devices
Year: 2026
Type: review
Study designs: Systematic Review, Meta-Analysis
Abstract: Background/Objectives: Type 2 Diabetes Mellitus (T2DM) is a prevalent metabolic disorder associated with major cardiovascular and metabolic complications. Regular physical activity is recommended for glycaemic management, but barriers such as obesity, joint pain, and impaired mobility may limit participation in land-based exercise. Aquatic exercise may provide a feasible alternative as water buoyancy reduces joint loading while allowing aerobic and resistance training. This systematic review and meta-analysis evaluated the effects of aquatic exercise interventions on glycaemic control in adults with T2DM. Methods: The review followed the PRISMA 2020 guidelines. MEDLINE, Cochrane CENTRAL, Scopus, Web of Science, and IEEE Xplore databases were searched. Randomised and non-randomised longitudinal studies involving adults aged ≥35 years with T2DM participating in structured aquatic exercise programmes were eligible. The primary outcome was glycated haemoglobin (HbA1c). Risk of bias was assessed using RoB 2 and RoBANS 2, and certainty of evidence was evaluated using GRADE. Random-effects meta-analysis calculated mean differences (MDs) with 95% confidence intervals. Results: Eleven randomised controlled trials involving 335 participants were included. Aquatic exercise significantly reduced HbA1c compared with passive control conditions (MD = −0.76%; 95% CI −1.21 to −0.32), although heterogeneity was high. No significant differences were observed between aquatic and land-based exercise interventions. Eight studies used wearable heart-rate monitors to regulate exercise intensity. Conclusions: Aquatic exercise may improve glycaemic control compared with sedentary conditions and yields effects comparable to those of land-based exercise in adults with T2DM. Further high-quality trials are needed to clarify optimal exercise dose–response and evaluate more advanced wearable technologies.
Source: Healthcare
Authors: Josiane Nicolle Pereira, Francisco A. Ferreira, Vinícius Costa Lima
Institution: Universidade do Porto
Language: English
Topic: Physical Activity and Health
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,258
OpenAlex ID: W7153224874