<![CDATA[Background: Adults with type 2 diabetes mellitus (T2DM), excess adiposity, and knee osteoarthritis (OA) require exercise prescriptions that address cardiometabolic risk without unnecessarily increasing joint symptoms.Aims: This randomized controlled trial evaluated whether 12 weeks of home-based hybrid multicomponent exercise training (HMET) altered metabolic (FBG), hemodynamic (SBP/DBP), anthropometric (BMI), and walking-capacity (6MWD) outcomes in adults with diabesity and radiographic knee OA.Methods: Forty-two adults aged >50 years with T2DM, BMI ≥23 kg/m², and Kellgren-Lawrence grade 2–3 knee OA were randomized 1:1 to HMET (n = 21) or control (n = 21). HMET was performed three times weekly. Prespecified co-outcomes were BMI, fasting blood glucose (FBG), systolic and diastolic blood pressure (SBP/DBP), and 6-minute walk distance (6MWD). Group × time effects were evaluated using repeated-measures ANOVA; Holm-adjusted p-values were used as a multiplicity sensitivity analysis. Results: The group × time interaction was strongest for FBG [F(1,40) = 8.83, nominal p = .005, Holm p = .025, partial η² = .18], with an HMET-versus-control difference in change of −82.0 mg/dL (95% CI −137.7 to −26.2). DBP showed a nominal interaction [F(1,40) = 4.31, p = .044, Holm p = .176, partial η² = .10; difference in change −4.9 mmHg, 95% CI −9.7 to −0.1], but did not remain statistically significant after multiplicity adjustment. Interactions for BMI, SBP, and 6MWD were not statistically significant. All 42 participants completed follow-up; HMET adherence was ≥90%, and no adverse events were recorded.Conclusion: Twelve-week home-based HMET produced a statistically significant FBG group × time effect after Holm adjustment and a more tentative DBP signal, without statistically significant evidence of parallel change in BMI, SBP, or 6MWD. These findings support further confirmatory trials with a prespecified primary endpoint and longer follow-up.]]>
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