Anthropometric, Cardiopulmonary and Metabolic Benefits of the High-Intensity Interval Training Versus Moderate, Low-Intensity or Control for Type 2 Diabetes: Systematic Review and Meta-Analysis

Abstract

This study aims to evaluate the effectiveness of high-intensity interval training compared with no intervention and other types of training interventions for people with Type 2 diabetes. A systematic review and meta-analysis of randomized controlled trials that used high-interval intensity training to improve anthropometric, cardiopulmonary and metabolic conditions were conducted. The search was performed during October–December 2017 using the databases PubMed, Web of Science and Physiotherapy Evidence Database (PEDro). The methodological quality of the studies was evaluated using the PEDro scale. A total of 10 articles were included in this meta-analysis. After statistical analysis, favorable results were obtained for high-Intensity Interval Training compared with control (non-intervention): [Weight: Standardized mean difference (SMD) = −2.09; confidence interval (CI) 95%: (−3.41; −0.78); body-mass index: SMD = −3.73; CI 95%: (−5.53; −1.93); systolic blood pressure: SMD = −4.55; CI 95%: (−8.44; −0.65); VO2max: SMD = 12.20; CI 95%: (0.26; 24.14); HbA1c: SMD = −3.72; CI 95%: (−7.34; −0.10)], moderate intensity continuous training: [body-mass index: SMD = −0.41; CI 95%: (−0.80; −0.03); VO2max: SMD = 1.91; CI 95%: (0.18; 3.64)], and low intensity training: [Weight: SMD = −2.06; CI 95%: (−2.80; −1.31); body-mass index: SMD = −3.04; CI 95%: (−5.16; −0.92); systolic blood pressure: SMD = −2.17; CI 95%: (−3.93; −0.41); HbA1c: SMD = −1.58; CI 95%: (−1.84; −1.33)]. The results show that high-intensity interval training can be a useful strategy in order to improve anthropometric, cardiopulmonary and metabolic parameters in people with Type 2 diabetes. Despite this, it could be essential to clarify and unify criteria in the intervention protocols, being necessary new lines of research.

The Urgent Need for Recommending Physical Activity for the Management of Diabetes During and Beyond COVID-19 Outbreak

“…: increase in resting heart rate and body fat, dysregulation of insulin and glucose secretion, decrease in the levels of GLUT-4 transporter, loss of training-induced improvements in cholesterol and HbA1C levels) and functional consequences (i.e. : reduction of aerobic, muscle strength, flexibility, balance and agility performance) after short periods of interruption of aerobic and/or resistance exercise programs (24)(25)(26)(27)(28)(29). It is important to note that the potential requirement of cocooning (a more severe form of physical distance measures) or FIGURE 2 | Estimated cases of diabetes and all-cause mortality attributed for physical inactivity, before and after COVID-19 pandemic.…”

“…Regarding to prevention and treatment of diabetes, lifestyle interventions are recommended to be based on a well-structured physical activity program (physical exercise) and a healthy nutritional behavior (13), and physical exercise is essential for improving glycemic control, insulin signaling, blood lipids, low-grade inflammation, vascular function, body composition and others health variables (35). Systematic reviews with meta-analysis have showed that most of above mentioned benefits of physical exercise can be obtained by aerobic and/or resistance exercise programs (25,(36)(37)(38)(39). For example, a recent-meta-analysis of 37 studies involving 2208 individuals with diabetes showed that both supervised aerobic or resistance exercise were effective for promoting substantial improvements in HbA1C, total cholesterol and triglycerides; however, only aerobic exercise improved fasting plasma glucose and low-density lipoprotein cholesterol, while only resistance exercise improved systolic blood pressure (37).…”

“…Systematic reviews with meta-analysis have showed that most of above mentioned benefits of physical exercise can be obtained by aerobic and/or resistance exercise programs ( 25 , 36 – 39 ). For example, a recent-meta-analysis of 37 studies involving 2208 individuals with diabetes showed that both supervised aerobic or resistance exercise were effective for promoting substantial improvements in HbA1C, total cholesterol and triglycerides; however, only aerobic exercise improved fasting plasma glucose and low-density lipoprotein cholesterol, while only resistance exercise improved systolic blood pressure ( 37 ).…”

“…For example, a recent-meta-analysis of 37 studies involving 2208 individuals with diabetes showed that both supervised aerobic or resistance exercise were effective for promoting substantial improvements in HbA1C, total cholesterol and triglycerides; however, only aerobic exercise improved fasting plasma glucose and low-density lipoprotein cholesterol, while only resistance exercise improved systolic blood pressure ( 37 ). It is important to note that the benefits of aerobic exercise appears to be associated with its intensity, with high-intensity exercise inducing superior effects in HbA1c, insulin, body weight, body mass index, VO 2MAX , lipid profile, C reactive protein, interleukin 6, and systolic blood pressure when compared to low and moderate intensities ( 25 , 36 , 38 ).…”

The impact of high‐intensity interval training on inflammatory markers in metabolic disorders: A meta‐analysis

“…In addition, sprint interval training (SIT) is another type of interval training usually performed at intensities equal to or greater than the pace that would elicit a peak in VO2 33 . There is accumulating evidence from meta‐analysis and systematic reviews supporting improved cardiometabolic health in overweight/obese and T2D, 34,35 decreased fat‐mass in adults, 36 enhanced aerobic capacity in healthy, young people, 37 and vascular function in patients 38 following HIIT. However, currently, no studies have comprehensively examined the effect of HIIT on inflammatory cytokines and adipokines 34,38 for which effects have been mixed 39‐42 .…”