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Background In order to recommend the optimal type of exercise for type 2 diabetes prevention, different exercise interventions were compared with respect to their effects on glycemic control and insulin resistance. Methods Studies on the curative effect of aerobic exercise training (AET), resistance training (RT), or control training (CT) on prediabetes were retrieved from the PubMed, Embase, SPORTDiscus, and Cochrane Library databases. Body mass index (BMI); homeostasis model assessment of insulin resistance index (HOMA-IR); and fasting blood glucose (FBG), glycated hemoglobin (HbA1c), and insulin levels were used as outcome indicators. The Q statistic was calculated to evaluate heterogeneity within studies. A fixed- or random-effects model was used for pooling data based on nonsignificant or significant heterogeneities. A consistency test was conducted using a node-splitting analysis. Results A total of 13 eligible studies were included. The results of the direct meta-analysis indicated that AET or RT could significantly reduce the HbA1c level in prediabetic individuals compared to CT [AET vs. CT: standardized mean difference (SMD) = − 0.6739, 95% confidence interval (CI) = − 0.9424 to − 0.4055 to RT vs. CT: SMD = − 1.0014, 95% CI = − 1.3582 to − 0.6446]. The findings from the network meta-analysis showed that there were no statistical differences among the four comparisons for all the indicators except for lower HbA1c level (SMD = − 0.75, 95% CI = − 1.31 to − 0.19) and HOMA-IR (SMD = − 1.03, 95% CI = − 1.96 to − 0.10) in the AET group than in the CT group. In addition, prediabetic individuals in the AET + RT group showed greater control of BMI and insulin and FBG levels than those in the other groups, whereas AET was the most effective in controlling HbA1c and HOMA-IR levels in prediabetic individuals. Conclusion AET, AET + RT, and RT exerted beneficial effects on insulin resistance and glycemic control in prediabetic patients. From the existing data, AET or AET + RT is preferentially recommended for these patients, although further studies may unveil RT as a promising therapy. Benefits from all types of exercise seem to occur in an intensity-dependent manner.

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Background: In order to recommend the optimum type of exercise for type 2 diabetes prevention, the effect of different exercise interventions on glycaemic control and insulin resistance relative indicators were compared. Methods: The studies involving the curative effect of aerobic exercise trailing (AET) or resistance trailing (RT) for prediabetes were searched with pre-established strategy . The Body Mass Index (BMI), fasting blood glucose (FBG), glycated haemoglobin (HbA1c), Insulin and homeostasis model assessment-insulin resistance index (HOMAIR) were used as outcomes indictors. Q statistic was calculated to evaluate the heterogeneity within studies. A fixed effects model was chosen for pooling data with p > 0.05, otherwise, a random effects model was chosen. The consistency test in this network meta-analysis was conducted by Node-splitting analysis. Results: A total of 12 eligible studies were included into this network meta-analysis. According to p score values, prediabetes individuals in AET group had better curative effect in BMI (p score = 0.7525), Insulin (p score = 0.6411) and HOMAIR (p score = 0.6411) value controls than in other groups, while the curative effect of RT on FBG (p score = 0.8465) and HbA1c (p score = 0.8550) values were optimum. The rank of P-scores for each indicator under above two effect models was basically consistent, indicating that our results of network meta-analysis were stable. Conclusions: AET might be a better intervene method for improving insulin resistance to prediabetes, while RT was more effective than AET, AET+RT or CT for glycaemic control in prediabetes.