High-intensity interval training in Diabetes Mellitus: A short systematic review
DOI:
https://doi.org/10.12775/JEHS.2025.80.58458Keywords
diabetes, HIIT – high-intensity interval training, glycemic control, insulin resistance, cardiovascular fitness, trainingAbstract
In recent decades, diabetes has become a prominent health concern in the developed world, with numerous researchers suggesting that it should be designated as the pandemic of the 21st century. Both type 1 and type 2 diabetes are on the rise, yet the latter poses a particularly significant threat. It is important to note that in a substantial number of cases, the underlying risk factors for type 2 diabetes are amenable to modification, highlighting the potential for preventative strategies. A major contributing factor is low physical activity, which significantly impedes disease control once it has developed.HIIT has been identified as a potentially effective and time-saving physical activity alternative for people with and at risk of diabetes. A comprehensive analysis of 12 papers from the 513 papers in the PubMed database was conducted, highlighting the substantial benefits of HIIT, including the immediate reduction in glucose levels post-training and the enhancement of the daily glycaemic profile due to increased insulin sensitivity of tissues. Similar observations were made regarding the reduction in systolic blood pressure and pro-inflammatory cytokines.
References
[1] P. D. Thompson, S. F. Crouse, B. Goodpaster, D. Kelley, N. Moyna, and L. Pescatello, "The acute versus the chronic response to exercise," Med Sci Sports Exerc, vol. 33, no. 6 Suppl, pp. S438-45; discussion S452-3, Jun 2001, doi: 10.1097/00005768-200106001-00012.
[2] F. W. Booth, C. K. Roberts, and M. J. Laye, "Lack of exercise is a major cause of chronic diseases," Compr Physiol, vol. 2, no. 2, pp. 1143-211, Apr 2012, doi: 10.1002/cphy.c110025.
[3] E. Ginter and V. Simko, "Type 2 diabetes mellitus, pandemic in 21st century," Adv Exp Med Biol, vol. 771, pp. 42-50, 2012, doi: 10.1007/978-1-4614-5441-0_6.
[4] S. Klein, A. Gastaldelli, H. Yki-Jarvinen, and P. E. Scherer, "Why does obesity cause diabetes?," Cell Metab, vol. 34, no. 1, pp. 11-20, Jan 4 2022, doi: 10.1016/j.cmet.2021.12.012.
[5] J. S. Rana, T. Y. Li, J. E. Manson, and F. B. Hu, "Adiposity compared with physical inactivity and risk of type 2 diabetes in women," Diabetes Care, vol. 30, no. 1, pp. 53-8, Jan 2007, doi: 10.2337/dc06-1456.
[6] L. M. Jaacks, K. R. Siegel, U. P. Gujral, and K. M. Narayan, "Type 2 diabetes: A 21st century epidemic," Best Pract Res Clin Endocrinol Metab, vol. 30, no. 3, pp. 331-43, Jun 2016, doi: 10.1016/j.beem.2016.05.003.
[7] E. Standl, K. Khunti, T. B. Hansen, and O. Schnell, "The global epidemics of diabetes in the 21st century: Current situation and perspectives," Eur J Prev Cardiol, vol. 26, no. 2_suppl, pp. 7-14, Dec 2019, doi: 10.1177/2047487319881021.
[8] M. Wei, L. W. Gibbons, J. B. Kampert, M. Z. Nichaman, and S. N. Blair, "Low cardiorespiratory fitness and physical inactivity as predictors of mortality in men with type 2 diabetes," Ann Intern Med, vol. 132, no. 8, pp. 605-11, Apr 18 2000, doi: 10.7326/0003-4819-132-8-200004180-00002.
[9] T. S. Church et al., "Exercise capacity and body composition as predictors of mortality among men with diabetes," Diabetes Care, vol. 27, no. 1, pp. 83-8, Jan 2004, doi: 10.2337/diacare.27.1.83.
[10] F. Magkos, Y. Tsekouras, S. A. Kavouras, B. Mittendorfer, and L. S. Sidossis, "Improved insulin sensitivity after a single bout of exercise is curvilinearly related to exercise energy expenditure," Clin Sci (Lond), vol. 114, no. 1, pp. 59-64, Jan 2008, doi: 10.1042/CS20070134.
[11] L. B. Borghouts and H. A. Keizer, "Exercise and insulin sensitivity: a review," Int J Sports Med, vol. 21, no. 1, pp. 1-12, Jan 2000, doi: 10.1055/s-2000-8847.
[12] C. T. Voldstedlund et al., "Exercise-induced increase in muscle insulin sensitivity in men is amplified when assessed using a meal test," Diabetologia, vol. 67, no. 7, pp. 1386-1398, Jul 2024, doi: 10.1007/s00125-024-06148-x.
[13] A. Kumar, R. Gangwar, A. A. Zargar, R. Kumar, and A. Sharma, "Prevalence of Diabetes in India: A Review of IDF Diabetes Atlas 10th Edition," Curr Diabetes Rev, vol. 20, no. 1, p. e130423215752, 2024, doi: 10.2174/1573399819666230413094200.
[14] P. Saeedi et al., "Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9(th) edition," Diabetes Res Clin Pract, vol. 157, p. 107843, Nov 2019, doi: 10.1016/j.diabres.2019.107843.
[15] M. A. Espinoza, T. Abbott, A. Passi, and C. Balmaceda, "Health and economic effects on patients with type 2 diabetes mellitus in the long run: predictions for the Chilean population," Diabetol Metab Syndr, vol. 14, no. 1, p. 155, Oct 26 2022, doi: 10.1186/s13098-022-00928-4.
[16] R. N. Oputa and P. U. Oputa, "Chronic Complications of Diabetes Mellitus," West Afr J Med, vol. 41, no. 8, pp. 904-908, Aug 30 2024. [Online]. Available: https://www.ncbi.nlm.nih.gov/pubmed/39737491.
[17] T. Yang et al., "An update on chronic complications of diabetes mellitus: from molecular mechanisms to therapeutic strategies with a focus on metabolic memory," Mol Med, vol. 30, no. 1, p. 71, May 26 2024, doi: 10.1186/s10020-024-00824-9.
[18] H. Shao, S. Yang, V. Fonseca, C. Stoecker, and L. Shi, "Estimating Quality of Life Decrements Due to Diabetes Complications in the United States: The Health Utility Index (HUI) Diabetes Complication Equation," Pharmacoeconomics, vol. 37, no. 7, pp. 921-929, Jul 2019, doi: 10.1007/s40273-019-00775-8.
[19] B. K. Bailes, "Diabetes mellitus and its chronic complications," AORN J, vol. 76, no. 2, pp. 266-76, 278-82; quiz 283-6, Aug 2002, doi: 10.1016/s0001-2092(06)61065-x.
[20] A. T. De Nardi, T. Tolves, T. L. Lenzi, L. U. Signori, and A. Silva, "High-intensity interval training versus continuous training on physiological and metabolic variables in prediabetes and type 2 diabetes: A meta-analysis," Diabetes Res Clin Pract, vol. 137, pp. 149-159, Mar 2018, doi: 10.1016/j.diabres.2017.12.017.
[21] B. R. MacIntosh, J. M. Murias, D. A. Keir, and J. M. Weir, "What Is Moderate to Vigorous Exercise Intensity?," Front Physiol, vol. 12, p. 682233, 2021, doi: 10.3389/fphys.2021.682233.
[22] J. A. Dugan, "Exercise recommendations for patients with type 2 diabetes," JAAPA, vol. 29, no. 1, pp. 13-8;quiz 1, Jan 2016, doi: 10.1097/01.JAA.0000475460.77476.f6.
[23] J. A. Kanaley et al., "Exercise/Physical Activity in Individuals with Type 2 Diabetes: A Consensus Statement from the American College of Sports Medicine," Med Sci Sports Exerc, vol. 54, no. 2, pp. 353-368, Feb 1 2022, doi: 10.1249/MSS.0000000000002800.
[24] G. Zhao, E. S. Ford, C. Li, and A. H. Mokdad, "Compliance with physical activity recommendations in US adults with diabetes," Diabet Med, vol. 25, no. 2, pp. 221-7, Feb 2008, doi: 10.1111/j.1464-5491.2007.02332.x.
[25] A. M. Egan et al., "Barriers to exercise in obese patients with type 2 diabetes," QJM, vol. 106, no. 7, pp. 635-8, Jul 2013, doi: 10.1093/qjmed/hct075.
[26] S. Healy et al., "It's about time to exercise: development of the Exercise Participation Explained in Relation to Time (EXPERT) model," Br J Sports Med, vol. 58, no. 19, pp. 1131-1144, Oct 17 2024, doi: 10.1136/bjsports-2024-108500.
[27] Y. Herazo-Beltran, Y. Pinillos, J. Vidarte, E. Crissien, D. Suarez, and R. Garcia, "Predictors of perceived barriers to physical activity in the general adult population: a cross-sectional study," Braz J Phys Ther, vol. 21, no. 1, pp. 44-50, Jan-Feb 2017, doi: 10.1016/j.bjpt.2016.04.003.
[28] Y. S. Koh et al., "A cross-sectional study on the perceived barriers to physical activity and their associations with domain-specific physical activity and sedentary behaviour," BMC Public Health, vol. 22, no. 1, p. 1051, May 26 2022, doi: 10.1186/s12889-022-13431-2.
[29] K. Y. Wolin, G. G. Bennett, L. H. McNeill, G. Sorensen, and K. M. Emmons, "Low discretionary time as a barrier to physical activity and intervention uptake," Am J Health Behav, vol. 32, no. 6, pp. 563-9, Nov-Dec 2008, doi: 10.5555/ajhb.2008.32.6.563.
[30] S. Ito, "High-intensity interval training for health benefits and care of cardiac diseases - The key to an efficient exercise protocol," World J Cardiol, vol. 11, no. 7, pp. 171-188, Jul 26 2019, doi: 10.4330/wjc.v11.i7.171.
[31] M. Nikseresht, V. Dabidi Roshan, and K. Nasiri, "Inflammatory markers and noncoding-RNAs responses to low and high compressions of HIIT with or without berberine supplementation in middle-aged men with prediabetes," Physiol Rep, vol. 12, no. 15, p. e16146, Aug 2024, doi: 10.14814/phy2.16146.
[32] A. Sabag, J. P. Little, and N. A. Johnson, "Low-volume high-intensity interval training for cardiometabolic health," J Physiol, vol. 600, no. 5, pp. 1013-1026, Mar 2022, doi: 10.1113/JP281210.
[33] M. E. Francois, C. Durrer, K. J. Pistawka, F. A. Halperin, and J. P. Little, "Resistance-based interval exercise acutely improves endothelial function in type 2 diabetes," Am J Physiol Heart Circ Physiol, vol. 311, no. 5, pp. H1258-H1267, Nov 1 2016, doi: 10.1152/ajpheart.00398.2016.
[34] K. Karstoft, C. S. Christensen, B. K. Pedersen, and T. P. Solomon, "The acute effects of interval- Vs continuous-walking exercise on glycemic control in subjects with type 2 diabetes: a crossover, controlled study," J Clin Endocrinol Metab, vol. 99, no. 9, pp. 3334-42, Sep 2014, doi: 10.1210/jc.2014-1837.
[35] T. Terada et al., "Targeting specific interstitial glycemic parameters with high-intensity interval exercise and fasted-state exercise in type 2 diabetes," Metabolism, vol. 65, no. 5, pp. 599-608, May 2016, doi: 10.1016/j.metabol.2016.01.003.
[36] H. A. Al-Rawaf, S. A. Gabr, A. Iqbal, and A. H. Alghadir, "High-Intensity Interval Training Improves Glycemic Control, Cellular Apoptosis, and Oxidative Stress of Type 2 Diabetic Patients," Medicina (Kaunas), vol. 59, no. 7, Jul 17 2023, doi: 10.3390/medicina59071320.
[37] C. Durrer, M. Francois, H. Neudorf, and J. P. Little, "Acute high-intensity interval exercise reduces human monocyte Toll-like receptor 2 expression in type 2 diabetes," Am J Physiol Regul Integr Comp Physiol, vol. 312, no. 4, pp. R529-R538, Apr 1 2017, doi: 10.1152/ajpregu.00348.2016.
[38] R. S. Metcalfe et al., "Extremely short duration interval exercise improves 24-h glycaemia in men with type 2 diabetes," Eur J Appl Physiol, vol. 118, no. 12, pp. 2551-2562, Dec 2018, doi: 10.1007/s00421-018-3980-2.
[39] E. Santiago et al., "Acute glycemic and pressure responses of continuous and interval aerobic exercise in patients with type 2 diabetes," Clin Exp Hypertens, vol. 40, no. 2, pp. 179-185, 2018, doi: 10.1080/10641963.2017.1339075.
[40] K. Minnebeck et al., "Four weeks of high-intensity interval training (HIIT) improve the cardiometabolic risk profile of overweight patients with type 1 diabetes mellitus (T1DM)," Eur J Sport Sci, vol. 21, no. 8, pp. 1193-1203, Aug 2021, doi: 10.1080/17461391.2020.1810782.
[41] R. Mendes, N. Sousa, J. L. Themudo-Barata, and V. M. Reis, "High-Intensity Interval Training Versus Moderate-Intensity Continuous Training in Middle-Aged and Older Patients with Type 2 Diabetes: A Randomized Controlled Crossover Trial of the Acute Effects of Treadmill Walking on Glycemic Control," Int J Environ Res Public Health, vol. 16, no. 21, Oct 28 2019, doi: 10.3390/ijerph16214163.
[42] S. N. Scott et al., "Fasted High-Intensity Interval and Moderate-Intensity Exercise Do Not Lead to Detrimental 24-Hour Blood Glucose Profiles," J Clin Endocrinol Metab, vol. 104, no. 1, pp. 111-117, Jan 1 2019, doi: 10.1210/jc.2018-01308.
[43] A. A. Viana, B. Fernandes, C. Alvarez, G. V. Guimaraes, and E. G. Ciolac, "Prescribing high-intensity interval exercise by RPE in individuals with type 2 diabetes: metabolic and hemodynamic responses," Appl Physiol Nutr Metab, vol. 44, no. 4, pp. 348-356, Apr 2019, doi: 10.1139/apnm-2018-0371.
[44] C. Baker et al., "Effect of low-volume exercise on hepatic steatosis in adults with obesity plus normal glucose, prediabetes or type 2 diabetes: a randomised controlled trial," BMJ Open Sport Exerc Med, vol. 10, no. 4, p. e001878, 2024, doi: 10.1136/bmjsem-2023-001878.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Mateusz Nieczyporuk, Aleksandra Sikora, Martyna Skweres, Szymon Pucyło, Katarzyna Ceglarz, Jan Pielaciński, Aleksander Rudnik, Kinga Sikora, Gabriela Piotrowska
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Stats
Number of views and downloads: 151
Number of citations: 0
