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Randomized Controlled Trial to Study the Acute Effects of Strength Exercise on Insulin Sensitivity in Obese Adults

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Long-Term Resistance Training and Risk of Type 2 Diabetes.

Tianyue Zhang^1,2, Yiwen Zhang^2,3, Dong Hoon Lee^2,4

¹Department of Endocrinology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.

JAMA Network Open

|June 22, 2026

Summary

Consistent resistance training, especially in midlife, significantly lowers type 2 diabetes (T2D) risk. Combining it with aerobic activity and limiting TV time further reduces T2D incidence.

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Area of Science:

Endocrinology
Preventive Medicine
Exercise Physiology

Background:

Optimal resistance training patterns for long-term health benefits, including diabetes prevention, are not well-defined.
Understanding the interplay between resistance training, aerobic activity, and sedentary behavior is crucial for public health guidelines.

Purpose of the Study:

To investigate the association between long-term resistance training patterns and the risk of developing type 2 diabetes (T2D).
To evaluate the combined effects of resistance training, aerobic physical activity, and sedentary behavior on T2D risk.

Main Methods:

Prospective cohort study analyzing data from three large US health professional studies.
Resistance training volume and patterns were assessed over time (ages 40-60) using cumulative means and trajectory analyses.
Incident T2D was the primary outcome, analyzed using Cox proportional hazards regression with time-varying exposures.

Main Results:

Engaging in ≥2 hours/week of resistance training was linked to a 27% lower T2D risk compared to no training.
Consistently high resistance training (≥0.5 h/wk midlife) showed a 42% T2D risk reduction; a low-to-high pattern showed a 21% reduction.
The lowest T2D risk was observed in individuals meeting recommendations for both aerobic activity and resistance training while limiting TV viewing (HR=0.38).

Conclusions:

Consistent, long-term resistance training, particularly during midlife, is associated with a significantly reduced risk of type 2 diabetes.
Combining resistance training with adequate aerobic activity and reduced sedentary time offers synergistic benefits for diabetes prevention.
These findings underscore the importance of incorporating resistance training into lifestyle recommendations for preventing T2D.