The International Diabetes Federation (IDF) has released a report showing that the number of adults aged 20–79 years with diabetes has reached 537 million (1 in 10) worldwide by 2021 [1]. The Global Burden of Disease Study (GBD Study 2021) predicts that the overall age-standardized prevalence of diabetes is expected to increase by 59.7% globally between 2021 and 2050, and that the prevalence of diabetes will decline in no country, resulting in an estimated 1.31 billion people living with diabetes globally [2]. In diabetic patients, over 90% are diagnosed with type 2 diabetes (T2DM). This is primarily due to impaired pancreatic islet cell function, resulting in insufficient insulin secretion, and reduced sensitivity of peripheral target cells to insulin, leading to a state of insulin resistance. Consequently, patients experience abnormalities in both blood glucose and lipid metabolism [3]. Poorly managed diabetes can result in vascular and neurological complications, severely impacting the physical and mental health of patients, reducing their quality of life, and imposing significant economic burdens on both nations and healthcare systems. In 2021 alone, global health expenditures attributable to diabetes reached a staggering $966 billion, constituting 9% of total global health expenditures [1,4]. It is clear that diabetes has become a global threat to the security of health care systems that needs to be addressed.

A lack of physical activity is widely acknowledged as one of the primary risk factors for the development of type 2 diabetes mellitus (T2DM) and its associated complications. Promoting increased physical activity stands as a practical approach in preventing and treating T2DM, particularly when considering lifestyle-based interventions [5]. Furthermore, previous studies have demonstrated a strong correlation between the psychological well-being of individuals and their blood glucose and lipid levels in those diagnosed with T2DM: patients who have been in adverse psychological states such as anxiety and depression for an extended period have an increased secretion of stress hormones in their bodies, which leads to an increase in insulin resistance, resulting in the disruption of the patient's glycemic and lipid metabolism [6]; at the same time, the unfavorable psychological state may also, by influencing the patient's treatment compliance, changing behavioral patterns and other pathways, be further adversely affect patients' blood glucose and lipid regulation [7]. Therefore, regulating psychological state is also an important part of diabetes education and management [8].

Mind-body exercises, including yoga, Tai Chi, and Pilates, are holistic modalities of exercise that harmonize both the body and the mind, emphasizing the unity of physical and mental well-being. This kind of exercise can improve physical health, enhance psychological quality, as well as bringing pleasure and mental relaxation [9]. Currently, a variety of mind-body exercises have been used as recommended forms of exercise for the health management of T2DM patients by diabetes prevention and treatment guidelines in several countries. For example, the 2020 Edition of the Chinese Guidelines for the Prevention and Treatment of Type 2 Diabetes Mellitus advises adult patients with T2DM to engage in 150 minutes of physical activity per week at a moderate intensity level, including Tai Chi and dance. [10]; the latest guidelines issued by the American College of Sports Medicine also recommend that T2DM patients perform exercises such as Tai Chi, Pilates, and yoga to enhance their overall health [11].Several randomized controlled trials (RCTs) and meta-analyses have been conducted to evaluate the effects of mind-body exercise on glucose and lipid metabolism in T2DM patients. For example, Wang et al. pooled evidence from 19 RCTs and found that tai chi significantly improved blood glucose and lipid levels in patients with T2DM [12]; Dutta Deep et al. integrated 13 trials of yoga interventions in patients with T2DM and found that yoga improved their blood glucose and lipid parameters [13]. In addition, a study by Li et al. found that Baduanjin and Taijiquan significantly improved FBG, HbA1c, TC, and HDL in patients with T2DM compared with the control group and that Baduanjin may have a better therapeutic effect [14]. However, determining the relative benefits of various mind-body exercise approaches through randomized controlled trials or paired meta-analyses presents inherent difficulties. Therefore, this research aims to evaluate the effectiveness of different mind-body exercise modalities in improving glycemic and lipid regulation among individuals with T2DM. Our approach involves synthesizing available data through a network meta-analysis [15], enabling us to establish rankings for different interventions. This result serves to guide clinical decision-making and inform future research, while also offering T2DM patients insights into exercise options for their daily lives.