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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Traditional PRT is not effective for reducing liver fat in overweight/obese adults compared with placebo control. Although PRT has known metabolic benefits, an adequate volume of aerobic exercise should be promoted if liver fat is the therapeutic target.

Background Cardiovascular disease remains a leading cause of death in women. Despite the well-known benefits of cardiac rehabilitation, it remains underutilized, especially among women. Physical activity programs in the community, however, attract a large female population, suggesting that they overcome barriers to physical activity encountered by women. The characteristics of interventions that extend beyond the traditional cardiac rehabilitation model and promote physical activity merit examination. Objectives This narrative review aimed to: (a) summarize women’s barriers to attend cardiac rehabilitation; (b) examine the characteristics of community- and home-based physical activity or lifestyle coaching interventions; and (c) discuss which barriers may be addressed by these alternative programs. Methods Studies were included if they: (a) were published within the past 10 years; (b) included ≥70% women with a mean age ≥45 years; (c) implemented a community- or home-based physical activity intervention or a lifestyle education/behavioral coaching program; and (d) aimed to improve physical activity levels or physical function. Results Most interventions reported high (≥70%) participation rates and significant increases in physical activity levels at follow-up; some improved physical function and/or cardiovascular disease risk factors. Community- and home-based interventions address women’s cardiac rehabilitation barriers by: implementing appealing modes of physical activity (e.g. dancing, group-walking, technology-based balance exercises); adapting the program to meet participants’ needs; offering flexible options regarding timing and setting (e.g. closer to home, the workplace or faith-based institutions); and promoting social interactions. Conclusion Cardiac rehabilitation can be enhanced by understanding the specific needs of women; novel elements such as program offerings, convenient settings and opportunities for socialization should be considered when designing cardiac rehabilitation programs.

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

Highlights This is the first study examining the effect of acute aerobic exercise on central arterial stiffness, wave reflections, and hemodynamics in people with diabetes. A significant group × time interaction was found for changes in central systolic blood pressure and augmentation index at a heart rate of 75 bpm. A reduction in central systolic blood pressure was observed following high-intensity interval exercise; no changes were found after moderate-intensity continuous exercise or control. A reduction in augementation index at a heart rate of 75 bpm was observed following both types of aerobic exercise, but not control. This provides valuable insight into possible benefits with aerobic exercise and vascular health in diabetes.