EFFECTS OF SOLEUS PUSH-UP EXERCISE ON GLYCEMIC CONTROL IN PATIENTS WITH TYPE 2 DIABETES MELLITUS: A RANDOMIZED CONTROLLED TRIAL

Abstract

Objective: This study aimed to evaluate whether a 12-week seated soleus push-up exercise program, added to standard diabetes care, improves fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c) in patients with type 2 diabetes mellitus (T2DM). Methods: This open-label, two-arm randomized controlled trial was conducted at a tertiary care teaching hospital from October 15, 2025, to February 15, 2026. A total of 384 adults with T2DM were randomized equally to standard care alone or standard care plus seated soleus push-ups for 30 min/session, 5 days/week, for 12 weeks. The revised sample-size justification was based on a clinically meaningful 0.50%-point HbA1c difference, a standard deviation of 1.20, 90% power, a two-sided alpha of 0.05, and 15% anticipated attrition. FPG and HbA1c were measured at baseline and week 12. Treatment effects were assessed using group-by-time models and between-group change-score comparisons with Holm correction for the two primary outcomes. Results: All 384 randomized participants completed follow-up and were included in the intention-to-treat analysis. FPG decreased by 10.31±3.12 mg/dL in the control group and 22.58±12.99 mg/dL in the soleus push-up group. The adjusted between-group difference in change was −12.27 mg/dL (95% confidence interval [CI]: −14.17–−10.37; Cohen’s d = 1.30; adjusted p<0.001). HbA1c decreased by 0.35±0.09 and 0.69±0.34% points, respectively; the adjusted between-group difference was −0.34% points (95% CI: −0.39–−0.29; Cohen’s d=1.37; adjusted p<0.001). Although standardized effects were large, the absolute additional HbA1c reduction was below the 0.50% responder threshold. Conclusion: Seated soleus push-ups added to routine diabetes care improved FPG and HbA1c over 12 weeks. The intervention should be interpreted as an adjunctive strategy; the absolute HbA1c benefit was modest, and the findings require confirmation using active controls, objective adherence and activity monitoring, blinded outcome assessment, and longer multicenter follow-up.