Effects of exercise on cognitive function and glycated hemoglobin A1c among patients with type 2 diabetes mellitus and cognitive impairment: A systematic review and meta‐analysis

Aim To evaluate the effects of exercise versus without‐exercise group on global cognitive function, executive function, glycated hemoglobin A1c (HbA1c) and fasting plasma glucose in patients with type 2 diabetes mellitus and cognitive impairment. Methods A systematic search of Cqvip, SinoMed, Wanfang Data, CINAHL, Cochrane, Embase, Pubmed, Lippincott, Web of Science and Scopus was carried out. Randomized control trials were selected. The risk of bias was evaluated using the Cochrane Risk of Bias tool. The random‐effects model was used to obtain the pooled estimates. Results Eight trials with 884 participants were included. Exercise could significantly improve global cognitive function (standardized mean difference 0.82, 95% CI 0.53–1.12), executive function measured by the Trail‐Marking Test part B (mean difference −20.43, 95% CI −36.20, −4.66), glycated hemoglobin A1c (%; mean difference −0.58, 95% CI −0.88, −0.29) and fasting plasma glucose (mg/dL; mean difference −17.61, 95% CI −32.67, −2.54). Conclusions Exercise can improve cognitive function, glycated hemoglobin A1c and fasting plasma glucose among type 2 diabetes mellitus patients with cognitive impairment. Additional studies with higher methodological quality are expected to draw more definite conclusions. This finding could provide a reference for clinical decision‐making and guide future research initiatives. Geriatr Gerontol Int 2025; 25: 148–159 .