Effectiveness of high-intensity interval training on glycemic control and cardiorespiratory fitness in patients with type 2 diabetes: a systematic review and meta-analysis

Abstract

Aims The aim of this systematic review and meta-analysis was to quantify the effect of high-intensity interval training (HIIT) on glycemic control and cardiorespiratory fitness compared with moderate-intensity training (MICT) and no training at all in patients with type 2 diabetes (T2D). Methods Relevant articles were sourced from PubMed, Embase, the Web of Science, EBSCO, and the Cochrane Library. Randomized-controlled trials were included based upon the following criteria: participants were clinically diagnosed with T2D, outcomes that included glycemic control (e.g., hemoglobin A1c); body composition (e.g., body weight); cardiorespiratory fitness (e.g., VO 2peak ) are measured at baseline and post-intervention and compared with either a MICT or control group. Results Thirteen trials involving 345 patients were finally identified. HIIT elicited a significant reduction in BMI, body fat, HbA1c, fasting insulin, and VO 2peak in patients with type 2 diabetes. Regarding changes in the body composition of patients, HIIT showed a great improvement in body weight (mean difference: − 1.22 kg, 95% confidence interval [CI] − 2.23 to − 0.18, P = 0.02) and body mass index (mean difference: − 0.40 kg/m 2 , 95% CI − 0.78 to − 0.02, P = 0.04) than MICT did. Similar results were also found with respect to HbA1c (mean difference: − 0.37, 95% CI − 0.55 to − 0.19, P < 0.0001); relative VO 2peak (mean difference: 3.37 ml/kg/min, 95% CI 1.88 to 4.87, P < 0.0001); absolute VO 2peak (mean difference: 0.37 L/min, 95% CI 0.28 to 0.45, P < 0.00001). Conclusions HIIT may induce more positive effects in cardiopulmonary fitness than MICT in T2D patients.

Efficacy of 10‐20‐30 training versus moderate‐intensity continuous training on HbA1c, body composition and maximum oxygen uptake in male patients with type 2 diabetes: A randomized controlled trial

“…Exercise is considered a cornerstone in the treatment of type 2 diabetes (T2D), and moderate‐intensity continuous training (MICT) can lower HbA1c, reduce fat mass and increase maximum oxygen uptake (V˙O 2 max) . In recent years, meta‐analysis studies have concluded that high‐intensity interval training (HIIT) is superior to MICT in improving glycaemic control in patients with T2D . HIIT is characterized by a high aerobic load, whereas sprint interval training (SIT) is characterized by a high anaerobic load, consisting of short (10–30 seconds) all‐out sprints interspersed by long (2‐4 minute) recovery periods.…”

Effect of exercise on key pharmacokinetic parameters related to metformin absorption in healthy humans: A pilot study

“…The American Diabetes Association recommends at least 150 minutes of moderate‐intensity or vigorous exercise per week for T2D management, although a meta‐analysis by Umpierre et al indicates that exercising more than 150 minutes per week leads to a greater decline in hemoglobin A 1C compared with exercise of 150 minutes or less per week. Moreover, two recent meta‐analyses conclude that HIIE provides similar or greater benefits than moderate‐intensity continuous exercise to patients with T2D . Based on these outcomes, we constructed a prolonged exercise protocol including high‐intensity intermittent periods.…”

“…Moreover, two recent meta-analyses conclude that HIIE provides similar or greater benefits than moderate-intensity continuous exercise to patients with T2D. 4,5 Based on these outcomes, we constructed a prolonged exercise protocol including high-intensity intermittent periods. Consistent with our protocol, Nadeau 28 proposes 45-60 minutes of aerobic exercise (preferably HIIE) per day for managing T2D, while Sari-Sarraf et al 29 applied a combined continuous and interval aerobic exercise protocol lasting 54 minutes on patients with metabolic syndrome (most of whom suffered from T2D) for 16 weeks, resulting in a plethora of positive clinical effects.…”

“…Treatment of T2D includes diet, physical exercise and pharmacotherapy . Recent studies indicate that high‐intensity interval exercise (HIIE) is one of the most suitable exercise types for T2D treatment . As for pharmacotherapy, metformin is considered the first‐line agent in the management of T2D .…”

“…3 Recent studies indicate that high-intensity interval exercise (HIIE) is one of the most suitable exercise types for T2D treatment. 4,5 As for pharmacotherapy, metformin is considered the first-line agent in the management of T2D. 2 Metformin is a strong base, present as a hydrophilic cation in biological fluids.…”