Effects of an exercise-based program on neutrophil–lymphocyte ratio and glycemic control in individuals with young-onset diabetes: a randomized controlled trial

Objective: Young-onset type 2 diabetes mellitus (T2DM) is a new health challenge with rising prevalence and significant morbidity. Persistent low-grade systemic inflammation and poor glycemic control lead to early occurrence of complications. The objective of this study is to evaluate the effectiveness of exercise-based programs on the neutrophil–lymphocyte ratio (NLR) and glycemic parameters, specifically fasting blood glucose (FBG) and glycated Hemoglobin (HbA1c), in individuals with young-onset T2DM. Methods: This randomized controlled trial involved a total of 84 individuals with T2DM between the ages of 18 and 40 years, randomly and equally assigned to either intervention or control groups. The participants in both groups received standard diabetic care. While the participants in the intervention group received an additional 12-week exercise-based program, consisting of a combination of aerobic and resistance training with moderate-to-vigorous intensity. NLR, HbA1c, and FBG were assessed at baseline and at 24 weeks. The glycemic parameters were also assessed at 12 weeks. A linear mixed-effects model was used to analyze the outcome measures with participants as random effects. Results: We found a significant statistical difference between the intervention and control groups in NLR after 24 weeks (F = 107.3, p <0.001), also in HbA1c (F = 8.23, p <0.001) and FBG (F = 3.44, p <0.034) after 12 and 24 weeks, respectively. Conclusion: A 12-week exercise-based program consisting balanced regimen of aerobic and resistance training has a beneficial effect on NLR by reducing systemic inflammation and improving glycemic control in individuals with young-onset T2DM when compared to standard diabetic care alone. Trial registration: Clinical Trial Registry of India number: CTRI/2023/08/056051.