Objective To investigate the clinical efficacy and safety of the Shibaduanjin nursing regimen in elderly patients with type 2 diabetes mellitus (T2DM) complicated with frailty.

Methods A prospective, non-randomized, concurrent, parallel-controlled clinical study was conducted. Elderly patients with T2DM and frailty who were hospitalized or treated in the outpatient department of the Second Department of Nephrology and Endocrinology, Dongzhimen Hospital, Beijing University of Chinese Medicine between July and December 2025 were enrolled. The patients were divided into the control group and the Shibaduanjin group based on whether they received centralized training. The control group received routine diabetes nursing, while the Shibaduanjin group received the Shibaduanjin nursing regimen in addition to routine care. The changes in glycated hemoglobin (HbA1c), frailty-related indicators, physical function indicators, anthropometric indicators, four blood lipid parameters and safety indicators were compared between the two groups.

Results A total of 120 patients were enrolled, including 62 in the control group and 58 in the Shibaduanjin group. After 12 weeks of intervention, the improvement range of frailty, the decrease of HbA1c, and the Tilburg Frailty Indicator (TFI) score, Elderly Frailty Assessment Scale of Integrative Medicine (FI-TCM) index, grip strength, 6-meter walking speed, Short Physical Performance Battery (SPPB) score, Visual Analogue Scale (VAS) score, fat-free mass index, appendicular skeletal muscle index, triglyceride, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol of the Shibaduanjin group were significantly better than those of the control group (all P < 0.05), while there were no significant differences in body mass index, waist circumference, hip circumference, body fat rate, appendicular skeletal muscle mass and total cholesterol, between the two groups (all P > 0.05). There were no significant differences in the incidence of hypoglycemia, falls and sports injuries between the two groups (all P > 0.05).

Conclusion The Shibaduanjin nursing regimen can significantly improve frailty status, glycemic control, physical function and body composition of elderly patients with T2DM complicated with frailty, with good safety, and is worthy of clinical promotion and application.

1. WangR, LuoS, WangP, et al. Estimating the burden of adult diabetes in China: a systematic review and Meta-analysis with attributable risk assessment[J]. BMC Public Health, 2025, 25(1): 3734. doi：10.1186/s12889-025-24626-8

2. KalladiR, ElavallyS, RojanPM, et al. Frailty: an overview[J]. J Family Med Prim Care, 2026, 15(1): 39-44. doi：10.4103/jfmpc.jfmpc_1748_25

3. LiuY, ZhangL, LiX, et al. Prevalence and risk factors of frailty in older adults with diabetes: a systematic review and Meta-analysis[J]. PLoS One, 2024, 19(10): e0309837. doi：10.1371/journal.pone.0309837

4. SantulliG, SabatelliG, WangB, et al. Interplay between frailty and cardiometabolic disorders: from pathophysiology to clinical implications[J]. Cardiovasc Diabetol, 2025, 25(1): 1. doi：10.1186/s12933-025-03022-x

5. RussoC, ValleMS, CambriaMT, et al. Inflammatory crosstalk between type 2 diabetes and sarcopenia: insights from in silico evaluation[J]. Int J Mol Sci, 2025, 26(16): 7932. doi：10.3390/ijms26167932

6. Rodriguez-MañasL, LaosaO, VellasB, et al. Effectiveness of a multimodal intervention in functionally impaired older people with type 2 diabetes mellitus[J]. J Cachexia Sarcopenia Muscle, 2019, 10(4): 721-733. doi：10.1002/jcsm.12432

7. 《中国老年2型糖尿病防治临床指南》编写组. 中国老年2型糖尿病防治临床指南(2022年版)[J]. 中国糖尿病杂志, 2022, 30(1): 2-51.Clinical guidelines for the prevention and treatment of type 2 diabetes mellitus in older adults in China (2022 edition)[J]. Chinese Journal of Diabetes, 2022, 30(1): 2-51.

8. 吕仁和. 和吕仁和教授一起练习十八段锦(三)[J]. 糖尿病新世界, 2006, 9(3): 38-39.LyuRH. Practicing shibaduanjin with professor Lyu Renhe (part 3)[J]. Diabetes New World, 2006, 9(3): 38‑39.

9. 吕仁和. 和吕仁和教授一起练习十八段锦(四)[J]. 糖尿病新世界, 2006, 9(4): 32-33.LyuRH. Practicing shibaduanjin with professor Lyu Renhe (part 4)[J]. Diabetes New World, 2006, 9(4): 32-33.

10. GobbensRJJ, van AssenMALM, LuijkxKG, et al. The Tilburg frailty indicator: psychometric properties[J]. J Am Med Dir Assoc, 2010, 11(5): 344-355. doi：10.1016/j.jamda.2009.11.003

11. 奚兴, 郭桂芳, 孙静. 中文版 Tilburg 衰弱评估量表的信效度研究[J]. 护理学报, 2013, 20(16): 1-5.XiX, GuoGF, SunJ. Reliability and validity of the Chinese version of Tilburg frailty indicator[J]. Journal of Nursing (China), 2013, 20 (16): 1-5.

12. 关欣, 黄飞, 闫小光, 等. 《中西医结合老年衰弱评估量表》的构建研究[J]. 北京中医药, 2018, 37(3): 202-205, 211.GuanX, HuangF, YanXG, et al. Development of elderly frailty assessment scale of integrative medicine[J]. Beijing Journal of Traditional Chinese Medicine, 2018, 37(3): 202-205, 211.

13. 乔琳琳, 闫小光, 黄飞, 等. 《中西医结合老年衰弱评估量表》的临床应用[J]. 北京中医药,2018, 37(3): 206-208.QiaoLL, YanXG, HuangF, et al. Clinical application of elderly frailty assessment scale of integrative medicine[J]. Beijing Journal of Traditional Chinese Medicine, 2018, 37(3): 206-208.

14. GuralnikJM, SimonsickEM, FerrucciL, et al. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission[J]. J Gerontol, 1995, 50(2): M85-M94. doi：10.1093/geronj/49.2.m85

15. HuskissonEC. Measurement of pain[J]. Lancet, 1974, 2(7889): 1127-1131. doi：10.1016/s0140-6736(74)90884-8

16. KohnJN, LoboJD, TroyerEA, et al. Tai Chi versus health education as a frailty intervention for community-dwelling older adults with hypertension[J]. Aging Clin Exp Res, 2023, 35(10): 2051-2060. doi：10.1007/s40520-023-02504-w

17. 郑丽维, 范维英, 邹连玉, 等. 八段锦对老年高血压伴衰弱患者的影响[J]. 护理学杂志, 2021, 36(24): 90-93, 97. doi：10.3870/j.issn.1001-4152.2021.24.090ZhengLW, FanWY, ZouLY, et al. Effect of Baduanjin exercise on elderly hypertensive patients with frailty[J]. Journal of Nursing Science, 2021, 36(24): 90-93, 97. doi：10.3870/j.issn.1001-4152.2021.24.090

18. UmpierreD, RibeiroPA, KramerCK, et al. Physical activity advice only or structured exercise training and association with HbA1c levels in type 2 diabetes: a systematic review and Meta-analysis[J]. JAMA, 2011, 305(17): 1790-1799.

19. RichterEA. Is GLUT4 translocation the answer to exercise-stimulated muscle glucose uptake?[J]. Am J Physiol Endocrinol Metab, 2021, 320(2): E240-E243. doi：10.1152/ajpendo.00503.2020

20. ZhangQ, GuoY, ZhangH, et al. Effects of aerobic, resistance, interval, and combined training on glucose metabolism in older adults: insights into type, dose, and mechanism[J]. Front Physiol, 2025, 16: 1702669. doi：10.3389/fphys.2025.1702669

21. HuangCY, MayerPK, WuMY, et al. The effect of Tai Chi in elderly individuals with sarcopenia and frailty: a systematic review and Meta-analysis of randomized controlled trials[J]. Ageing Res Rev, 2022, 82: 101747. doi：10.1016/j.arr.2022.101747

22. WuK, ChenX, LongK, et al. Efficacy of Baduanjin exercise for sarcopenia in older adults: a 24-week randomized controlled trial[J]. J Cachexia Sarcopenia Muscle, 2025, 16(6): e70163. doi：10.1002/jcsm.70163

23. PanXH, MahemutiA, ZhangXH, et al. Effect of Tai Chi exercise on blood lipid profiles: a Meta-analysis of randomized controlled trials[J]. J Zhejiang Univ Sci B, 2016, 17 (8): 640-648. doi：10.1631/jzus.b1600052

24. FeingoldKR. Introduction to lipids and lipoproteins [M/OL]//Feingold KR, Adler RA, Ahmed SF, et al. Endotext [OL]. South Dartmouth (MA): MDText.com, Inc.,2024(2024-01-14)[2026-10-15]. https://www.ncbi.nlm.nih.gov/books/NBK305896/.

25. MarquesLR, DinizTA, AntunesBM, et al. Reverse cholesterol transport: molecular mechanisms and the non-medical approach to enhance HDL cholesterol[J]. Front Physiol, 2018, 9: 526. doi：10.3389/fphys.2018.00526