Strength training is a primary tool for diabetes management

This 9-month trial of 186 normal-weight adults with type 2 diabetes, normal weight and low muscle mass, compared strength training, aerobic exercise, and both combined. Strength training alone most effectively lowered blood sugar (HbA1c −0.44%, p=0.002), outperforming aerobic exercise alone. The benefit came from increasing muscle mass relative to fat—critical since muscles use 80% of blood glucose. Limitations: 83% Asian participants, 30% dropout rate, most took diabetes medications. Participants are all with normal weight but low muscle mass. Classification: "Tested in Humans" (RCT, n=186, passed all quality checks). Recommendations: Larger diverse studies, longer follow-up beyond 9 months, research across different diabetes types (type 1, prediabetes) would strengthen evidence.