The purpose of this study was to examine the effect of regular exercise training on insulin sensitivity in adults with type 2 diabetes mellitus (T2DM) using the pooled data available from randomised controlled trials. In addition, we sought to determine whether short-term periods of physical inactivity diminish the exercise-induced improvement in insulin sensitivity. Eligible trials included exercise interventions that involved ≥3 exercise sessions, and reported a dynamic measurement of insulin sensitivity. There was a significant pooled effect size (ES) for the effect of exercise on insulin sensitivity (ES, –0.588; 95% confidence interval [CI], –0.816 to –0.359; P<0.001). Of the 14 studies included for meta-analyses, nine studies reported the time of data collection from the last exercise bout. There was a significant improvement in insulin sensitivity in favour of exercise versus control between 48 and 72 hours after exercise (ES, –0.702; 95% CI, –1.392 to –0.012; P=0.046); and this persisted when insulin sensitivity was measured more than 72 hours after the last exercise session (ES, –0.890; 95% CI, –1.675 to –0.105; P=0.026). Regular exercise has a significant benefit on insulin sensitivity in adults with T2DM and this may persist beyond 72 hours after the last exercise session.

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The aim of this study was to examine the effect of a novel low-volume high-intensity interval training (HIIT), moderate-intensity continuous training (MICT), or placebo (PLA) intervention on liver fat, glycemia, and cardiorespiratory fitness using a randomized placebo-controlled design. RESEARCH DESIGN AND METHODSThirty-five inactive adults (age 54.6 6 1.4 years, 54% male; BMI 35.9 6 0.9 kg/m 2 ) with obesity and type 2 diabetes were randomized to 12 weeks of supervised MICT (n 5 12) at 60% VO 2peak for 45 min, 3 days/week; HIIT (n 5 12) at 90% VO 2peak for 4 min, 3 days/week; or PLA (n 5 11). Liver fat percentage was quantified through proton MRS. RESULTSLiver fat reduced in MICT (20.9 6 0.7%) and HIIT (21.7 6 1.1%) but increased in PLA (1.2 6 0.5%) (P 5 0.046). HbA 1c improved in MICT (20.3 6 0.3%) and HIIT (20.3 6 0.3%) but not in PLA (0.5 6 0.2%) (P 5 0.014). Cardiorespiratory fitness improved in MICT (2.3 6 1.2 mL/kg/min) and HIIT (1.1 6 0.5 mL/kg/min) but not in PLA (21.5 6 0.9 mL/kg/min) (P 5 0.006). CONCLUSIONSMICT or a low-volume HIIT approach involving 12 min of weekly high-intensity aerobic exercise may improve liver fat, glycemia, and cardiorespiratory fitness in people with type 2 diabetes in the absence of weight loss. Further studies are required to elucidate the relationship between exercise-induced reductions in liver fat and improvements in glycemia.Type 2 diabetes is a polygenic disorder involving interactions between genetic and environmental risk factors, resulting in hepatic and muscle insulin resistance and pancreatic b-cell dysfunction (1,2). Ectopic fat is a term used to describe the excess accumulation of fat in nonadipose tissue (2,3), with ectopic fat in the liver being closely linked to the development, progression, and severity of diabetes (4). Individuals with type 2 diabetes have increased amounts of ectopic fat that cannot be simply explained by excess body weight (5). Furthermore, insulin resistance plays a critical role in the pathogenesis and progression of nonalcoholic fatty liver disease, which is highly prevalent in individuals with type 2 diabetes (6,7). Consequently, preventing and