MIND-BODY exercises (MBEs) such as yoga, meditation, and mindfulness are increasingly popular among individuals with type 2 diabetes mellitus (T2D), but their relative effectiveness for managing cardiometabolic risk factors has remained unclear. A new network meta-analysis of randomised controlled trials (RCTs) has now provided comparative insights, suggesting that certain MBEs may offer significant advantages over conventional exercise interventions. Researchers observed that Mindfulness Intervention Training (MIT) and other MBEs may deliver superior improvements in key metabolic and cardiovascular outcomes.
Following PRISMA guidelines, researchers conducted a systematic search across major databases including PubMed, Cochrane Library, Web of Science, and Embase up to 15 December 2024. RCTs were included if they evaluated MBEs against control or other interventions for their impact on glucose metabolism, lipid levels, cardiovascular physiology, or body composition in people with T2D. Data extraction and bias assessment were performed independently by two reviewers using the RoB 2 tool. A network meta-analysis was carried out using R and Stata, reporting mean differences (MD) and standardised mean differences (SMD). Evidence quality was evaluated with the CINeMA framework.
The analysis covered ten cardiometabolic risk factors across various MBEs. Meditative Exercise (ME) was found to be the most effective at reducing fasting plasma glucose (SMD = -7.23; 95% CI: -8.27–-6.20; SUCRA=97.9%), while MIT had the strongest impact on HbA1c levels (MD = -0.78; 95% CI: -1.12–-0.44; SUCRA=92.2%) and blood pressure (systolic blood pressure [SBP]: MD=-13.00 mmHg; diastolic blood pressure [DBP]: MD=-6.00 mmHg). Yoga with Meditation (YWM) was associated with the greatest reduction in BMI (MD=-2.90; 95% CI: -4.05–-1.75). Although most comparisons were rated as very low certainty due to study heterogeneity and within-study bias, the absence of publication bias and support from node-splitting analysis suggest the findings are robust.
These findings highlight the potential for personalised integration of MBEs in diabetes care. Clinicians may consider recommending specific practices such as MIT for blood pressure and HbA1c control, or YWM for weight management. However, the short duration and variability of the interventions across studies limit definitive clinical guidance. Further long-term trials are needed to establish optimal protocols and to assess sustainability and adherence in real-world settings.
Reference
Li X et al. Comparative efficacy of various mind-body exercise types on cardiometabolic health in patients with type 2 diabetes: a network meta-analysis of randomized controlled trials. B<C Cardiovasc Disord. 2025;25(1):291
