Optimal exercise parameters of Baduanjin for improving glycemic and lipid control in type 2 diabetes: a systematic review and meta-analysis

Background: This meta-analysis explores the optimal exercise parameters of Baduanjin for improving glucose and lipid metabolism in patients with type 2 diabetes mellitus (T2DM). Method: This meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eight databases were searched for randomized controlled trials (RCTs) published from their inception to April 30, 2025. Studies quality and risk of bias were assessed using the Cochrane Risk of Bias tool version 2 (RoB 2). Meta-analysis was performed using R software (version 4.4.2), primarily utilizing the meta and metafor packages. The certainty of evidence was assessed using the Grading Recommendations, Assessment, Development and Evaluation (GRADE) approach. The study protocol was registered in PROSPERO https://www.crd.york.ac.uk/PROSPERO/view/CRD42023480517. Results: = 84.2%) and glycated hemoglobin (WMD = -0.67, 95% CI: -0.81 to -0.53, P < 0.0001, I² = 69.9%) in patients with T2DM, with a substantial effect on triglycerides (WMD = -0.37, 95% CI: -0.57 to -0.16, P < 0.0001, I² = 84.7%). Improvements in total cholesterol (WMD = -0.40, 95% CI: -0.56 to -0.25, P < 0.0001, I² = 86.6%) were comparatively modest. This study suggests potentially optimal exercise parameters for Baduanjin practice: 40-45 minutes per session, three times weekly, for a minimum duration of 24-48 weeks. Conclusion: Baduanjin significantly improves glucose and lipid metabolism in patients with T2DM. Our findings suggest that three sessions per week, each lasting 40-45 minutes, with an intervention duration of 24-48 weeks, may represent the optimal parameters for metabolic improvement. Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier Identifier CRD42023480517.