<b>Combined Effects of Balance Training with Moderate-Intensity Aerobic Versus Resistance Training on Glycemic Control, Cardiorespiratory Fitness, and Quality of Life in Type 2 Diabetes Mellitus Patients</b>

Background: Type 2 diabetes mellitus (T2DM) is a prevalent metabolic disorder associated with serious micro- and macrovascular complications, with diabetic neuropathy contributing to impaired balance, reduced mobility, and diminished quality of life. Exercise interventions are integral to T2DM management, but evidence comparing the combined effects of balance training with aerobic versus resistance training on clinical and patient-reported outcomes remains limited. Objective: To determine the comparative effects of balance training combined with moderate-intensity aerobic versus resistance training on glycemic control, cardiorespiratory fitness, and quality of life in adults with T2DM and diabetic neuropathy. Methods: In this randomized controlled trial, 46 adults aged 40–60 years with T2DM and diabetic neuropathy were randomized to receive 12 weeks of balance plus aerobic training or balance plus resistance training, 3–5 days per week. Primary outcomes were HbA1c, VO₂max, and EQ-5D-5L (VAS) scores, assessed pre- and post-intervention. Non-parametric tests analyzed within- and between-group differences. Results: Both interventions produced significant improvements in all outcomes (p<0.001), but aerobic plus balance training achieved superior reductions in HbA1c (7.33% vs. 7.65%, p=0.027), greater gains in EQ-5D-5L (VAS) (+36.9 vs. +31.7 points, p<0.001), and better balance scores (p=0.040). Conclusion: Balance training combined with moderate-intensity aerobic exercise was superior to resistance training in improving glycemic control, balance, and quality of life in T2DM patients with neuropathy.