{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T11:54:07Z","timestamp":1793188447008,"version":"4.5.0"},"reference-count":44,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T00:00:00Z","timestamp":1759881600000},"content-version":"vor","delay-in-days":280,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100007073","name":"University of Mohaghegh Ardabili","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007073","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Diabetes Research"],"published-print":{"date-parts":[[2025,1]]},"abstract":"\n Objective<\/jats:title>\n This randomized controlled trial evaluated the differential effects of aerobic training (AT), resistance training (RT), and combined training (CT) on biphasic insulin secretion and glucose effectiveness (GE) in patients with Type 2 diabetes mellitus (T2DM).<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Forty\u2010five male T2DM patients (mean age: 55.24 \u00b1 8.17 years; disease duration: 12.51 \u00b1 6.46 years; baseline HbA1c: 7.1\n %<\/jats:italic>\n \u00b1 1.0\n %<\/jats:italic>\n ) were randomized to 12\u2010week AT (\n n<\/jats:italic>\n = 11), RT (\n n<\/jats:italic>\n = 11), CT (\n n<\/jats:italic>\n = 11), or control (\n n<\/jats:italic>\n = 12) groups. AT involved progressive aerobic exercise (25\u201345\u2009min at 70%\u201375% maximum heart rate, thrice weekly). RT comprised nine multijoint exercises (2\u20133 sets, 8\u201312 repetitions, thrice weekly). CT combined the full AT protocol with a modified RT regimen (one set, twice weekly). First\u2010phase insulin secretion (FPIS), second\u2010phase insulin secretion (SPIS), and GE were quantified using validated models pre\u2010 and postintervention.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Adjusting for baseline values, age, and diabetes duration, ANCOVA revealed significant between\u2010group differences in FPIS (\n F<\/jats:italic>\n [3, 38] = 8.64,\n p<\/jats:italic>\n < 0.001,\n \u03b7<\/jats:italic>\n 2<\/jats:sup>\n = 0.406), SPIS (\n F<\/jats:italic>\n [3, 38] = 6.93,\n p<\/jats:italic>\n < 0.001,\n \u03b7<\/jats:italic>\n 2<\/jats:sup>\n = 0.354), and GE (\n F<\/jats:italic>\n [3, 38] = 5.57,\n p<\/jats:italic>\n = 0.003,\n \u03b7<\/jats:italic>\n 2<\/jats:sup>\n = 0.305). CT elicited the greatest improvements: FPIS (53.4\n %<\/jats:italic>\n \u00b1 12.7\n %<\/jats:italic>\n ,\n p<\/jats:italic>\n < 0.001), SPIS (38.9\n %<\/jats:italic>\n \u00b1 11.2\n %<\/jats:italic>\n ,\n p<\/jats:italic>\n < 0.001), and GE (12.8\n %<\/jats:italic>\n \u00b1 4.6\n %<\/jats:italic>\n ,\n p<\/jats:italic>\n = 0.001) versus control. AT enhanced FPIS (32.6\n %<\/jats:italic>\n \u00b1 10.3\n %<\/jats:italic>\n ,\n p<\/jats:italic>\n = 0.001) and SPIS (21.7\n %<\/jats:italic>\n \u00b1 8.9\n %<\/jats:italic>\n ,\n p<\/jats:italic>\n = 0.042), while RT improved FPIS (28.5\n %<\/jats:italic>\n \u00b1 9.8\n %<\/jats:italic>\n ,\n p<\/jats:italic>\n = 0.006), SPIS (27.5\n %<\/jats:italic>\n \u00b1 9.4\n %<\/jats:italic>\n ,\n p<\/jats:italic>\n = 0.012), and GE (10.7\n %<\/jats:italic>\n \u00b1 4.3\n %<\/jats:italic>\n ,\n p<\/jats:italic>\n = 0.004). Regression analysis identified baseline\n \u03b2<\/jats:italic>\n \u2010cell function (\n \u03b2<\/jats:italic>\n = \u22120.31,\n p<\/jats:italic>\n = 0.020), adiposity reduction (\n \u03b2<\/jats:italic>\n = \u22120.36,\n p<\/jats:italic>\n = 0.008), and glycemic improvement (\n \u03b2<\/jats:italic>\n = \u22120.42,\n p<\/jats:italic>\n = 0.003) as predictors of FPIS gains (\n R<\/jats:italic>\n 2<\/jats:sup>\n = 0.537).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n CT outperforms single\u2010modality training in enhancing biphasic insulin secretion and GE in T2DM, supporting multimodal exercise as a cornerstone of diabetes management to improve\n \u03b2<\/jats:italic>\n \u2010cell function and glycemic control.\n <\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n ClinicalTrials.gov identifier: IRCT2016042227529N1<\/jats:p>\n 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