Effectiveness of high‐intensity interval training combined with resistance training versus continuous moderate‐intensity training combined with resistance training in patients with type 2 diabetes: A one‐year randomized controlled trial

Abstract

Aims To evaluate the impact of one‐year high intensity interval training (HIIT) combined with resistance training (RT) vs continuous moderate intensity training (MCT) combined with RT on glycaemic control, body composition and cardiorespiratory fitness (CRF) in patients with type 2 diabetes. Materials and Methods A randomized controlled trial included 96 participants with type 2 diabetes for a one‐year supervised exercise intervention with three groups: Control, HIIT with RT and MCT with RT). The control group received standard counseling regarding general PA guidelines, with no structured exercise sessions. The main outcome variable was HbA1c (%). Secondary outcomes were other glycaemic variables, body composition, anthropometry measurements, CRF and enjoyment of exercise. Generalized estimating equations (GEE) were used to model outcomes. Results Among the 96 participants enrolled in the intervention, 80 were randomized, with a mean (SD) age of 58.5 years (7.7) and a mean HbA1c of 7.2% (1.6). After adjusting the model for sex and total moderate‐to‐vigorous physical activity (MVPA), we found that both the MCT with RT (β, 0.003; P, 0.921) and the HIIT with RT (β, 0.025; P, 0.385) groups had no effect on HbA1c. A favourable effect was observed in the MCT with RT group, with a reduction in whole body fat index (β, −0.062; P, 0.022), android fat index (β, −0.010; P, 0.010) and gynoid fat index (β, −0.013; P, 0.014). Additionally, CRF increased during the intervention, but only in the MCT with RT group (β, 0.185; P, 0.019). Conclusions The results from this study suggest that there was no effect of either MCT with RT or HIIT with RT on glycaemic control in individuals with type 2 diabetes. However, the combination of MCT and RT improved body composition and CRF following a one‐year intervention.

Impact of Combined Training with Different Exercise Intensities on Inflammatory and Lipid Markers in Type 2 Diabetes: A Secondary Analysis from a 1-Year Randomized Controlled Trial

“…In contrast, decreased values have only been observed with dietary-induced weight loss (6), suggesting that sCD163 changes are dependent on body weight loss, particularly that of adipose tissue, which leads to a reduction of in ltrated active macrophages. Nevertheless, even with total and abdominal body fat reduction, as previously reported in the main ndings of this study (18), the MCT group did not display corresponding decreases in sCD163…”

“…Additional PPA was performed in only those who completed both assessments (i.e. baseline and 1-year), in patients who had at least 70% of attendance of the total exercise sessions, and in those without substantial changes in pharmacological therapy (18). Data analyses were performed using SPSS Statistics version 22.0 (SPSS Inc., an IBM Company, Chicago, Illinois, USA).…”

“…The complete study protocol has been previously published (18). Brie y, individuals with T2DM were recruited to analyse the impact of a 1-year exercise intervention with different intensities on glycated haemoglobin (HbA1c) (clinicaltrials.gov ID:NCT03144505).…”

“…Eighty patients were recruited within the Lisbon Metropolitan Area (Fig. 1) (18), and posteriorly randomized into three groups (control, HIIT with RT or MCT with RT). An external researcher, with an allocation ratio of 1:1:1, used a computer-generated list of random numbers, for the randomization process.…”

Sedentary behavior compensation to 1‐year exercise RCT in patients with type 2 diabetes

“…21 There is a major limitation that is related with the fact that the study protocol and power sample calculations were not conceived for the goals of this secondary analysis, Thus, it is possible that this study might be under powered since the initial calculations were made based on glycated hemoglobin differences. 22 To assess this assumption, we did an additional power sample calculation, based on the means and SDs for sedentary time presented by the three groups at the final month of intervention and assuming an α of .05 and a power of .95, with an actual effect size of .47. The results yielded an addition of seven participants to demonstrate the numerical "differences" as significant.…”