Effects of Acute and Chronic Exercise in Hypoxia on Cardiovascular and Glycemic Parameters in Patients with Type 2 Diabetes: A Systematic Review

Eight Weeks of Intermittent Exercise in Hypoxia, with or without a Low-Carbohydrate Diet, Improves Bone Mass and Functional and Physiological Capacity in Older Adults with Type 2 Diabetes

“…However, aerobic and strength EH at 2000 m of simulated altitude (FiO 2 = ~16.5%) did not seem to be sufficient to obtain improvements after eight weeks, both in the glycemic profile and cardiorespiratory capacity, in this same population [ 65 ]. Therefore, EH’s benefits may occur with simulated altitudes over 3000 m [ 30 ]. Improvements in both the glycemic profile and VO 2peak seem to influence improvements in bone metabolism in patients with T2DM [ 44 ].…”

“…In this context, moderate hypoxia, between 2500 m and 3000 m of simulated altitude, most often leads to beneficial effects [ 29 ]. It is suggested that specific adaptations induced by hypoxia are mediated mainly by the increase in the hypoxia-induced transcription factor 1α (HIF-1α), which, in addition to offering potentially therapeutic effects for bone health by inducing an osteogenic–angiogenic response [ 28 ], promotes improvements in glucose metabolism in patients with T2DM to a greater extent than in normoxic conditions [ 30 ]. In older adults, EH has shown to be beneficial to cognitive performance and quality of life [ 31 ], functional capacity [ 32 ], and bone health [ 33 ].…”

Combined low-carbohydrate diet and long-term exercise in hypoxia in type 2 diabetes: A randomized controlled trial protocol to assess glycemic control, cardiovascular risk factors and body composition

“…To circumvent this and improve dietary adherence, the present study assumed a lower carbohydrate restriction, consisting of 40% of the energy intake, which also has demonstrated benefits in metabolic control in patients with T2DM during 8 weeks (van Zuuren et al, 2018). Also, the currently available studies have some methodological flaws, such as non-randomized or uncontrolled clinical trials (Kindlovits et al, 2022) and insufficient supervision of the reasons for non-adherence to prescribed LCDs (McArdle et al, 2019). These limitations make it difficult to translate their results into clinical practice.…”

“…Also, the currently available studies have some methodological flaws, such as non-randomized or uncontrolled clinical trials ( Kindlovits et al, 2022 ) and insufficient supervision of the reasons for non-adherence to prescribed LCDs ( McArdle et al, 2019 ). These limitations make it difficult to translate their results into clinical practice.…”

“…Few studies have analyzed the effects of EH on glycemic and lipid profiles, on cardiorespiratory physiology or on angiogenesis in T2DM ( Kindlovits et al, 2022 ). Furthermore, none of them evaluated HIF1-α levels, which is frequently destabilized in patients with T2DM ( Thangarajah et al, 2010 ).…”