High-Intensity Interval Training Is Equivalent to Moderate-Intensity Continuous Training for Short- and Medium-Term Outcomes of Glucose Control, Cardiometabolic Risk, and Microvascular Complication Markers in Men With Type 2 Diabetes

Abstract

We sought to determine the efficacy of 12 weeks high-intensity interval training (HIIT), compared to moderate-intensity continuous training (MICT) on glucose control, cardiometabolic risk and microvascular complication markers in men living with type 2 diabetes (T2D). Both modalities were combined with resistance training (RT). Additionally, the study aimed to determine the medium-term durability of effects. After a 12-week, thrice weekly, training intervention incorporating either MICT+RT (n = 11) or HIIT+RT (n = 12), the study concluded with a 6-month follow-up analysis. The middle-aged study participants were obese, had moderate duration T2D and were taking multiple medications including insulin, statins and beta-blockers. Participants, randomized via the method of minimization, performed MICT (progressing to 26-min at 55% maximum estimated workload [eWLmax]) or HIIT (progressing to two variations in which twelve 1-min bouts at 95% eWLmax interspersed with 1-min recovery bouts, alternated with eight 30-s bouts at 120% eWLmax interspersed with 2:15 min recovery bouts) under supervision at an exercise physiology facility. To account for fixed and random effects within the study sample, mixed-effect models were used to determine the significance of change following the intervention and follow-up phases and to evaluate group*time interactions. Beyond improvements in aerobic capacity (P < 0.001) for both groups, both training modalities elicited similar group*time interactions (P > 0.05) while experiencing benefits for glycated hemoglobin (HbA1c; P = 0.01), subcutaneous adiposity (P < 0.001), and heart rate variability (P = 0.02) during the 12-week intervention. Adiposity (P < 0.001) and aerobic capacity (P < 0.001) were significantly maintained in both groups at the 6-month follow-up. In addition, during the intervention, participants in both MICT+RT and HIIT+RT experienced favorable reductions in their medication usage. The study reported the inter-individual variability of change within both groups, the exaggerated acute physiological responses (using exercise termination indicators) that occurred during the interventions as well as the incidence of precautionary respite afforded in such a study sample. To reduce hyperglycaemia, and prevent further deterioration of cardiometabolic risk and microvascular complication markers (in both the short- and medium-term), future strategies that integrate the adoption and maintenance of physical activity as a cornerstone in the treatment of T2M for men should (cognisant of appropriate supervision) include either structured MICT+RT, or HIIT+RT.Clinical Trials Registration Number: ACTRN12617000582358 http://www.anzctr.org.au/default.aspx

Effects of different protocols of high intensity interval training for VO2max improvements in adults: A meta-analysis of randomised controlled trials

“…It has been shown that these are even more beneficial for improving physical and mental health outcomes in healthy and diabetic populations. 19,20 HIIT protocols enable individuals who exercise to maintain at maximal or near maximal oxygen uptake (T@VO2max) for long periods of time, because a potent stimulus elicits both central (oxygen transport) and peripheral (oxygen utilization) adaptations for VO2max improvement. 7,21,22 Many different components of HIIT such as work intensity, bout duration, number of repetitions, and training periodization have been shown to have substantial influence on T@VO2max.…”

The effect of home-based low-volume, high-intensity interval training on cardiorespiratory fitness, body composition and cardiometabolic health in women of normal body mass and those with overweight or obesity: protocol for a randomized controlled trial

“…The most commonly observed primary outcome measure in HIIT studies is a change in peak oxygen consumption (VO 2 peak) as an indirect measure of improvement in cardiovascular disease risk [39]. Various other improvements in cardiometabolic health markers are also observed in trials investigating HIIT in adults with overweight/obesity, including reductions in systolic and diastolic blood pressure [40, 41], reversal of dyslipidemia [42, 43], improvements in insulin resistance, glycated haemoglobin (HbA1c) and fasting blood glucose concentrations [43–45]. The improvements in cardiometabolic risk factors are observed following both short term (< 12 weeks) and long term (> 12 weeks) participation in HIIT interventions despite no significant change in body composition [40].…”

Temporal Associations Among Body Mass Index, Fasting Insulin, and Systemic Inflammation

“…Of these, 753 articles were excluded, resulting in 60 that met the selection criteria and 5603 enrolled participants (of whom 5261 were analyzed). 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 ...…”

“…The durations of follow-up ranged from 1 to 60 months (median, 12 months). A total of 21 studies were from Western Europe, 25 , 27 , 41 , 54 , 61 , 62 , 65 , 72 , 81 , 82 , 84 11 from North America, 25 , 27 , 41 , 54 , 61 , 62 , 65 , 72 , 81 , 82 , 84 9 from East Asia, 29 , 38 , 39 , 44 , 51 , 52 , 60 , 66 , 68 5 from South America, 28 , 69 , 78 , 79 , 83 5 from Western Asia, 28 , 69 , 78 , 79 , 83 and 3 each from Africa, 35 , 50 , 76 the Pacific, 26 , 42 , 75 and Eastern Europe. 45 , 74 , 80 …”