A Pilates Exercise Program as a Therapeutic Strategy in Older Adults with Type 2 Diabetes: Effects on Functional Capacity and Blood Glucose

<b>Background/Objectives:</b> Older adults with type 2 diabetes mellitus (T2DM) often experience impaired physical function and metabolic control. This study aimed to evaluate the effectiveness of a 12-week Pilates-based intervention on blood glucose concentration and physical function in this population. <b>Methods:</b> A randomized controlled trial was conducted with 104 older adults (mean age: 70.6 ± 3.15 years; 70.2% women), all diagnosed with T2DM. The participants were assigned to a control group (CG, n = 52) or a Pilates training group (PG, n = 52). The intervention included 24 Pilates sessions over 12 weeks (2 sessions/week, 60 min each). Outcomes were assessed pre- and post-intervention and included capillary blood glucose, handgrip strength, functional mobility (Timed Up and Go), balance (Berg Balance Scale), and flexibility (Chair Sit-and-Reach Test and Back Scratch Test). <b>Results:</b> Compared to the control group, the Pilates group showed statistically significant improvements in blood glucose levels (-4.06 mg/dL (<i>p</i> < 0.001; d = 0.68)), handgrip strength (+1.76 kg (<i>p</i> < 0.001; d = 0.48)), gait speed (<i>p</i> < 0.001; d = 0.53), balance (Berg score) (+2.37 points (<i>p</i> < 0.001; d = 0.66)), and flexibility (improvements in upper limbs (BST, d = 0.78-0.98) and lower limbs (CSRT, d = 1.07 right; d = 0.63 left)). <b>Conclusions:</b> A 12-week Pilates program led to significant improvements in glycemic control, muscular strength, gait speed, balance, and flexibility in older adults with T2DM. These findings support Pilates as a safe, effective, and adaptable non-pharmacological intervention to promote functional and metabolic health in this population.