Comparison of Functional Inspiratory Muscle Training and Combined Exercise Training in Individuals With Type 2 Diabetes

November 2, 2026 updated by: İrem Çaylak Yetüt

Comparison of the Effects of Online Functional Inspiratory Muscle Training and Combined Exercise Training on Functional Capacity, Fatigue, and Balance in Individuals With Type 2 Diabetes

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disease that may impair exercise capacity, respiratory muscle strength, balance, and quality of life, and increase fatigue. Exercise training is an important component of diabetes management. However, the effects of functional inspiratory muscle training, which combines breathing exercises with functional movements and postural control activities, have not been sufficiently investigated in individuals with T2DM. This study aims to compare the effects of online functional inspiratory muscle training and combined exercise training on functional capacity, fatigue, and balance in individuals with T2DM. The study will also investigate changes in respiratory muscle strength, peripheral muscle strength, quality of life, and activities of daily living. This prospective, single-blind, randomized controlled trial will include 39 individuals aged 40-65 years who have been diagnosed with T2DM. Participants will be randomly assigned to three groups in a 1:1:1 ratio: a combined exercise training group, a functional inspiratory muscle training group, and a control group. Both exercise groups will participate in an eight-week home-based training program consisting of three sessions per week. Two sessions will be supervised online by a physiotherapist, while one session will be performed independently. The combined exercise training group will perform aerobic, resistance, and breathing exercises. The functional inspiratory muscle training group will perform progressive inspiratory muscle training combined with core stabilization, postural control, and functional exercises. The control group will receive physical activity counseling and an informational brochure without participating in a structured exercise intervention. Participants will be evaluated at baseline and after the eight-week intervention. The primary outcomes will be functional capacity, fatigue, and balance, assessed using the Six-Minute Walk Test, Functional Assessment of Chronic Illness Therapy-Fatigue Scale (FACIT-F), Timed Up and Go Test, and the short version of the Activities-specific Balance Confidence Scale. Secondary outcomes will include respiratory and peripheral muscle strength, lower-extremity functional performance, diabetes-related quality of life, instrumental activities of daily living, and anthropometric measurements. This study aims to provide evidence regarding the effectiveness of online functional inspiratory muscle training compared with combined exercise training in improving physical function and balance in individuals with T2DM.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Not yet recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
39

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Locations

  • Turkey (Türkiye)
    • Istanbul
      • Istanbul, Istanbul, Turkey (Türkiye), 34147
        • Istanbul University-Cerrahpasa
        • Contact:
        • Contact:
        • Principal Investigator:
          • İrem Çaylak Yetüt, PhD student
        • Sub-Investigator:
          • Gökşen Kuran Aslan, Professor
        • Sub-Investigator:
          • Lütfullah Caştur, MD

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

40 years to 65 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Having been diagnosed with type 2 diabetes mellitus (T2DM) for at least one year and being medically stable at the time of enrollment.
  • Age between 40 and 65 years of age.
  • Using oral hypoglycemic medications or insulin.
  • Having a pre-exercise blood glucose level between 90 and 250 mg/dL.
  • Having an HbA1c level between 6.5% and 11%.
  • Having access to an internet connection.
  • Being able to communicate in Turkish.
  • Having no visual impairment.

Exclusion Criteria:

  • Having participated in an exercise program within the previous six months.
  • Having a body mass index (BMI) ≥35 kg/m².
  • Having type 1 diabetes mellitus.
  • Having chronic obstructive pulmonary disease (COPD), interstitial lung disease, or asthma.
  • Having coronary artery disease.
  • Having neurological disorders.
  • Having musculoskeletal problems that may prevent participation in exercise training.
  • Having uncontrolled hypertension (systolic blood pressure ≥180 mmHg or diastolic blood pressure ≥120 mmHg).
  • Being pregnant or breastfeeding.
  • Having a thyroid disorder.
  • Having diabetic ulcers or peripheral neuropathy.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Combined Exercise Training Group
Behavioral: Combined Excerse Training

Participants allocated to the combined exercise training group will receive an eight-week online exercise program supervised by a physiotherapist. The program will include aerobic, resistance, and balance exercises aimed at improving functional capacity, peripheral muscle strength, and postural balance. Exercise intensity and progression will be individualized according to each participant's functional capacity and exercise tolerance.
Experimental: Control Group
Other: Usual Care

Participants allocated to the control group will continue their usual medical care during the eight-week study period. They will receive general education on type 2 diabetes management, the importance of physical activity, and healthy lifestyle habits. However, they will not participate in a structured exercise program or receive functional inspiratory muscle training or combined exercise training as part of the study.
Experimental: Functional Inspiratory Muscle Training Group
Behavioral: Functional Inspiratory Muscle Training

Participants allocated to the functional inspiratory muscle training group will receive an eight-week online inspiratory muscle training program using an inspiratory muscle training device. Training will be performed at 30-40% of maximal inspiratory pressure (MIP), for approximately 30 minutes per day, seven days per week. One session per week will be supervised online by a physiotherapist. Training intensity will be adjusted according to individual MIP measurements and exercise tolerance.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
six-minute walk distance
Time Frame: baseline and week 8

Functional capacity will be assessed using the Six-Minute Walk Test (6MWT). Participants will be instructed to walk as far as possible within six minutes. The total distance walked will be recorded in meters. Higher distances indicate better functional capacity.
baseline and week 8
Fatigue Level Assessed by FACİT-Fatigue Scale
Time Frame: Baseline and week 8

Fatigue will be assessed using the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) Scale. The scale consists of 13 items, with a total score ranging from 0 to 52. Higher scores indicate lower fatigue levels and better fatigue-related quality of life.
Baseline and week 8
Dynamic Balance Assessed by Timed Up and Go Test (TUG)
Time Frame: Baseline and week 8

Dynamic balance and functional mobility will be assessed using the Timed Up and Go (TUG) Test. Participants will stand up from a chair, walk three meters, turn around, return to the chair, and sit down. The completion time will be recorded in seconds. Lower values indicate better performance.
Baseline and week 8
Balance Confidence Assessed by Activities-specific Balance Confidence Scale (ABC)
Time Frame: Baseline and week 8

Balance confidence will be assessed using the Activities-specific Balance Confidence (ABC) Scale. Participants will rate their confidence in maintaining balance during daily activities. Scores range from 0% to 100%, with higher scores indicating greater balance confidence.
Baseline and week 8

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Peripheral Muscle Strength Assessed by Handheld Dynamometry
Time Frame: Baseline and week 8

Peripheral muscle strength will be assessed using a handheld dynamometer (KFORCE). Muscle strength measurements will be performed bilaterally for the selected upper- and lower-extremity muscle groups using standardized testing positions. Results will be recorded in the measurement units provided by the device. Higher values indicate greater muscle strength.
Baseline and week 8
Maximal Expiratory Pressure
Time Frame: Baseline and week 8

Expiratory muscle strength will be assessed by measuring maximal expiratory pressure (MEP) with a respiratory pressure-measuring device. Results will be expressed in cmH2O. Higher values indicate greater expiratory muscle strength.
Baseline and week 8
Diabetes-Related Quality of Life Assessed by DQoL-BCI
Time Frame: Baseline and week 8

Diabetes-related quality of life will be assessed using the Diabetes Quality of Life Brief Clinical Inventory (DQoL-BCI). This 15-item questionnaire evaluates the impact of diabetes on daily life, satisfaction with diabetes management, and diabetes-related concerns. Changes in quality of life will be assessed before and after the eight-week intervention.
Baseline and week 8
Instrumental Activities of Daily Living Assessed by Lawton-Brody Scale
Time Frame: Baseline and week 8

Instrumental activities of daily living will be assessed using the Lawton-Brody Instrumental Activities of Daily Living Scale. The scale evaluates independence in daily activities such as telephone use, shopping, food preparation, housekeeping, laundry, transportation, medication management, and financial management. Higher scores indicate greater independence in instrumental activities of daily living.
Baseline and week 8

Other Outcome Measures

Other Outcome Measures

For clinical trials, a planned measurement described in the protocol that is used to determine the effect of an intervention/treatment on participants. For observational studies, a measurement or observation that is used to describe patterns of diseases or traits, or associations with exposures, risk factors, or treatment. Types of outcome measures include primary outcome measure and secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Lower Extremity Functional Performance Assessed by the 30-Second Sit-to-Stand Test
Time Frame: Baseline and week 8

Lower extremity functional performance will be assessed using the 30-Second Sit-to-Stand Test (30STS). Participants will be instructed to stand up fully from a seated position and sit down as many times as possible within 30 seconds, without using their arms for assistance. The total number of correctly completed repetitions will be recorded. Higher repetition counts indicate better lower extremity functional performance.
Baseline and week 8
Waist Circumference
Time Frame: Baseline and week 8

Waist circumference will be measured using a non-elastic measuring tape and recorded in centimeters (cm). Measurements will be performed using a standardized anatomical landmark and measurement procedure. Changes in waist circumference will be evaluated from baseline to the end of the eight-week intervention.
Baseline and week 8

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
İrem Çaylak Yetüt

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Study Chair: Gökşen Kuran Aslan, Proffessor, Istanbul University - Cerrahpasa
  • Study Director: Lütfullah Caştur, MD, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
December 1, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
June 1, 2027

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
December 1, 2027

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
November 2, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
November 2, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
November 6, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
November 6, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
November 2, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
November 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • IUC-T2DM-IMT-2026

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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