{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T10:49:01Z","timestamp":1782989341189,"version":"3.54.5"},"reference-count":35,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:00:00Z","timestamp":1782691200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["American Journal of Lifestyle Medicine"],"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Type 2 diabetes mellitus (T2DM) is a major global and national public-health challenge. Most adults do not meet the aerobic and strength guidelines necessary for the prevention and management of the disease.\n                    <jats:bold>Purpose:<\/jats:bold>\n                    To synthesize evidence on how combined exercise training (CET: aerobic + resistance) affects cardiometabolic risk factors, adherence, and quality of life (QoL) in adults with T2DM; identify the impact of supervision features, and produce equity-focused, practice-ready recommendations.\n                    <jats:bold>Methods:<\/jats:bold>\n                    Narrative synthesis reporting CET effects on cardiometabolic risk factors, adherence, and QoL, emphasizing intervention parameters and supervision models.\n                    <jats:bold>Results:<\/jats:bold>\n                    CET consistently yields modest to clinically meaningful reductions in HbA1c and fasting glucose and improves body composition, lipids, blood pressure, vascular function, inflammatory markers (CRP, IL-6), myokine responses, and VO2max. Supervised CET produces larger effect sizes, greater adherence, better technique and safety, and stronger psychosocial benefits (self-efficacy, social support, QoL) than unsupervised\/usual-care programs. Heterogeneity in modalities (MICT, HIIT), resistance intensity\/equipment, scheduling, supervision models, outcome metrics, and underrepresentation of diverse populations limit definitive guidance.\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    Supervised CET effectively improves cardiometabolic health and QoL in adults with T2DM. Standardized reporting, head-to-head trials of scheduling and supervision, and pragmatic studies in diverse settings are needed to support scalable implementation.\n                  <\/jats:p>","DOI":"10.1177\/15598276261463126","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T15:29:15Z","timestamp":1782746955000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Combined Exercise Training and Supervision: Impact on Cardiometabolic Risk Factors, Adherence, and Quality of Life in Adults With Type 2 Diabetes"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-2223-2850","authenticated-orcid":false,"given":"Ava T.","family":"Donaldson","sequence":"first","affiliation":[{"name":"PennWest University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Oddi","sequence":"additional","affiliation":[{"name":"PennWest University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jodi","family":"Dusi","sequence":"additional","affiliation":[{"name":"PennWest University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6385-7640","authenticated-orcid":false,"given":"Brian","family":"F. Foster","sequence":"additional","affiliation":[{"name":"PennWest University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Federico","sequence":"additional","affiliation":[{"name":"PennWest University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,29]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)01301-6"},{"key":"e_1_3_3_3_2","unstructured":"World Health Organization. Diabetes. Published November 14 2024. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/diabetes. Accessed February 14 2026."},{"key":"e_1_3_3_4_2","unstructured":"International Diabetes Federation. Diabetes around the world in 2024: facts & figures. Published 2024. https:\/\/idf.org\/about-diabetes\/diabetes-facts-figures\/. Accessed February 14 2026."},{"key":"e_1_3_3_5_2","unstructured":"Centers for Disease Control and Prevention. National diabetes statistics report. Published 15 May 2024. https:\/\/www.cdc.gov\/diabetes\/php\/data-research\/index.html"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc25-S008"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijms21176275"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)32374-6"},{"key":"e_1_3_3_9_2","unstructured":"Centers for Disease Control and Prevention. 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