The effects of high intensity interval training (HIIT) on insulin sensitivity and metabolic health in adults with prediabetes
DOI:
https://doi.org/10.12775/QS.2026.77.76161Keywords
high intensity interval training, HIIT, prediabetes, impaired glucose tolerance, insulin sensivity, insulin resistance, pre-diabetesAbstract
Background. Prediabetes elevates lifetime risk of type 2 diabetes and cardiovascular disease. Moderate-intensity continuous training (MICT) improves metabolic health but is limited by time demands. High-intensity interval training (HIIT) is a time-efficient alternative that can match or exceed MICT benefits for insulin sensitivity and glycemic control, yet optimal protocols remain unclear.
Aim. To evaluate the effects of HIIT on insulin sensitivity and metabolic health in adults with prediabetes.
Material and methods. PubMed, Scopus and Google Scholar were searched for English-language peer-reviewed studies (2015–2026) on HIIT and insulin sensitivity or metabolic outcomes in adults with prediabetes. Eligible randomised controlled trials, controlled trials, observational studies and reviews were screened by title/abstract and full text after duplicate removal; reference lists were also hand-searched.
Results. HIIT improved muscle and whole-body insulin sensitivity, reduced fasting glucose and HbA1c, and increased VO₂max, often comparably to MICT despite lower time commitment. Higher-volume protocols yielded greater HbA1c reductions; greater volume also strengthened benefits for fasting glucose, insulin and HOMA-IR. Combined HIIT plus diet produced the best BMI outcomes, while clamp-derived insulin sensitivity improvements partly depended on ≥3 % weight loss. Superiority over MICT varied by outcome and protocol.
Conclusions. HIIT delivers meaningful gains in insulin sensitivity and metabolic health that are frequently comparable to MICT with substantially less time. Larger standardised trials are needed to define optimal, individualised prescriptions for type 2 diabetes prevention.
References
Mensberg, P., Frandsen, C., Carl, C. S., Espersen, E., Leineweber, T., Larsen, E. L., Storgaard, H., Schlawitz, K., Petersen, T. H. D., Poulsen, J. N., Sørensen, F., Gørtz, P. M., Forman, J. L., Kiens, B., Knop, F. K., & Vilsbøll, T. (2025). High-intensity interval training improves insulin sensitivity in individuals with prediabetes. European Journal of Endocrinology, 192(4), 456–465. https://doi.org/10.1093/ejendo/lvaf004
RezkAllah, S. S., & Takla, M. K. (2019). Effects of different dosages of interval training on glycemic control in people with prediabetes: A randomized controlled trial. Diabetes Spectrum, 32(2), 125–131. https://doi.org/10.2337/ds18-0024
Safarimosavi, S., Mohebbi, H., & Rohani, H. (2021). High-intensity interval vs. continuous endurance training: Preventive effects on hormonal changes and physiological adaptations in prediabetes patients. Journal of Strength and Conditioning Research, 35(3), 731–738. https://doi.org/10.1519/JSC.0000000000002709
Tene, T., Zambrano-Villacres, R., Puruncajas-Rodríguez, C. I., Tettamanti Miranda, D., Tello-Moreno, M. C., Campos-Moposita, A. P., Caiza Lema, S. J., Montalvan, M., & Tene-Fernandez, R. (2026). Effect of HIIT training modality in people with pre-diabetes. Journal of Functional Morphology and Kinesiology, 11(1), 48. https://doi.org/10.3390/jfmk11010048
Chen, X., Wu, L., et al. (2025). Effective of high-intensity interval training and moderate-intensity continuous training on body composition, glycolipid metabolism, and cardiopulmonary function in patients with pre-diabetes: A randomized controlled trial. Frontiers in Endocrinology, 16, 1614149. https://doi.org/10.3389/fendo.2025.1614149
Li, J., Yuan, J., Wang, F., Zeng, Q., Zhang, Y., & Ma, H. (2026). Effects of high-intensity interval training on glycemic control and cardiometabolic risk factors in adults with prediabetes: A systematic review and meta-analysis. Frontiers in Endocrinology DOI: https://doi.org/10.3389/fendo.2026.1837386
De Nardi, A. T., Tolves, T., Lenzi, T. L., Signori, L. U., & da Silva, A. M. V. (2018). High-intensity interval training versus continuous training on physiological and metabolic variables in prediabetes and type 2 diabetes: A meta-analysis. Diabetes Research and Clinical Practice, 137, 149–159. https://doi.org/10.1016/j.diabres.2017.12.017
Jelleyman, C., Yates, T., O’Donovan, G., Gray, L. J., King, J. A., Khunti, K., & Davies, M. J. (2015). The effects of high-intensity interval training on glucose regulation and insulin resistance: A meta-analysis. Obesity Reviews, 16(11), 942–961. https://doi.org/10.1111/obr.12317
Cassidy, S., Thoma, C., Houghton, D., Trenell, M. I. (2017). High-intensity interval training: A review of its impact on glucose control and cardiometabolic health. Diabetologia, 60(1), 7–23. https://doi.org/10.1007/s00125-016-4106-1
Lu, Y., Baker, J. S., Ying, S., & Lu, Y. (2025). Effects of practical models of low-volume high-intensity interval training on glycemic control and insulin resistance in adults: A systematic review and meta-analysis of randomized controlled studies. Frontiers in Endocrinology, 16, 1481200. https://doi.org/10.3389/fendo.2025.1481200
Mateo-Gallego, R., et al. (2022). The effects of high-intensity interval training on glucose metabolism, cardiorespiratory fitness and weight control in subjects with diabetes: Systematic review and meta-analysis. Diabetes Research and Clinical Practice, 190, 109979. https://doi.org/10.1016/j.diabres.2022.109979
Poon, E. T.-C., et al. (2025). Efficacy of high-intensity interval training in individuals with type 2 diabetes mellitus: An umbrella review of systematic reviews and meta-analyses. Diabetes, Obesity and Metabolism, 27(4), 1719–1734. https://doi.org/10.1111/dom.16220
Al-Mhanna, S. B., Poon, E.TC., Franklin, B.A et al. (2025). Comparative effectiveness of high-intensity interval training and moderate-intensity continuous training on cardiometabolic health in patients with diabesity: A systematic review and meta-analysis of randomized controlled trials. Diabetology & Metabolic Syndrome, 17, 331. https://doi.org/10.1186/s13098-025-01909-z
Al-Mhanna, S. B., Franklin, B.A., Tarnopolsky, M.A. et al. (2025). Impact of high-intensity interval training on cardiometabolic health in patients with diabesity: A systematic review and meta-analysis of randomized controlled trials. Diabetology & Metabolic Syndrome, 17, 406. https://doi.org/10.1186/s13098-025-01974-4
Feng, J., Zhang, Q., et al. (2024). Effects of high-intensity intermittent exercise on glucose and lipid metabolism in type 2 diabetes patients: A systematic review and meta-analysis. Frontiers in Endocrinology, 15, 1360998. https://doi.org/10.3389/fendo.2024.1360998
Álvarez, C., Ramírez-Campillo, R., et al. (2023). The effect of chronic high-intensity interval training programs on glycaemic control, aerobic resistance, and body composition in type 2 diabetic patients: A meta-analysis. Journal of Endocrinological Investigation, 46, 2423–2443. https://doi.org/10.1007/s40618-023-02144-x
Heiston, E. M., Eichner, N. Z., Gilbertson, N. M., & Malin, S. K. (2020). Exercise improves adiposopathy, insulin sensitivity and metabolic syndrome severity independent of intensity. Experimental Physiology, 105(4), 632–640. https://doi.org/10.1113/EP088158
DiMenna, F. J., & Arad, A. D. (2020). The acute vs. chronic effect of exercise on insulin sensitivity: Nothing lasts forever. Cardiovascular Endocrinology & Metabolism, 10(3), 149–161. https://doi.org/10.1097/XCE.0000000000000239
Mora-Rodriguez, R., Ortega, J. F., Ramirez-Jimenez, M., Moreno-Cabañas, A., & Morales-Palomo, F. (2020). Insulin sensitivity improvement with exercise training is mediated by body weight loss in subjects with metabolic syndrome. Diabetes & Metabolism, 46(3), 210–218. https://doi.org/10.1016/j.diabet.2019.05.004
Nikseresht, M., Dabidi Roshan, V., & Nasiri, K. (2024). Inflammatory markers and noncoding-RNAs responses to low and high compressions of HIIT with or without berberine supplementation in middle-aged men with prediabetes. Physiological Reports, 12(15), e16146. https://doi.org/10.14814/phy2.16146
Bartlett DB, Slentz CA, Willis LH, Hoselton A, Huebner JL, Kraus VB, Moss J, Muehlbauer MJ, Spielmann G, Muoio DM, Koves TR, Wu H, Huffman KM, Lord JM, Kraus WE. Rejuvenation of Neutrophil Functions in Association With Reduced Diabetes Risk Following Ten Weeks of Low-Volume High Intensity Interval Walking in Older Adults With Prediabetes - A Pilot Study. Front Immunol. 2020 May 5;11:729. doi: https://doi.org/10.3389/fimmu.2020.00729.
Badaam, K. M., & Zingade, U. S. (2021). The effect of traditional aerobic exercise and sprint interval training on insulin resistance in men with prediabetes: A randomised controlled trial. Cureus, 13(12), e20789. https://doi.org/10.7759/cureus.20789
Jeet, G., Sharma, A., Alshehri, M.M. et al. (2025). Therapeutic and preventive role of integrated moderate-to-vigorous recreational activity programs in type 2 diabetes care: A systematic review and meta-analysis. Advances in Therapy, 43, 650–665. https://doi.org/10.1007/s12325-025-03435-w
Desjardins, K., Taherkhani, S., Méthot, L., Castonguay, V., & Leduc-Gaudet, J.-P. (2024). Insights into the influence of high-intensity interval training on skeletal muscle clock gene expression in insulin-resistant individuals. The Journal of Physiology, 602(23), 6443–6444. https://doi.org/10.1113/JP286939
Ryan, B. J., Schleh, M. W., Ahn, C., Ludzki, A. C., Gillen, J. B., Varshney, P., ... & Horowitz, J. F. (2020). Moderate-intensity exercise and high-intensity interval training affect insulin sensitivity similarly in obese adults. The Journal of Clinical Endocrinology & Metabolism, 105(8), e2941–e2959. https://doi.org/10.1210/clinem/dgaa345
Sun F, Williams, C. A., Sun, Q., Hu, F., & Zhang, T. (2024). Effect of eight-week high-intensity interval training versus moderate-intensity continuous training programme on body composition, cardiometabolic risk factors in sedentary adolescents. Frontiers in Physiology, 15, 1450341. https://doi.org/10.3389/fphys.2024.1450341
Collins, K. A., Ross, L. M., Slentz, C. A., et al. (2022). Differential effects of amount, intensity, and mode of exercise training on insulin sensitivity and glucose homeostasis: A narrative review. Sports Medicine - Open, 8, 90. https://doi.org/10.1186/s40798-022-00480-5
Gillen, J. B., Martin, B. J., MacInnis, M. J., Skelly, L. E., Tarnopolsky, M. A., & Gibala, M. J. (2016). Twelve weeks of sprint interval training improves indices of cardiometabolic health similar to traditional endurance training despite a five-fold lower exercise volume and time commitment. PLoS ONE, 11(4), e0154075. https://doi.org/10.1371/journal.pone.0154075
Huang, L., Fang, Y. & Tang, L. (2021). Comparisons of different exercise interventions on glycemic control and insulin resistance in prediabetes: A network meta-analysis. BMC Endocrine Disorders, 21, 181. https://doi.org/10.1186/s12902-021-00846-y
Robinson, E., Durrer, C., Simtchouk, S., Jung, M. E., Bourne, J. E., Voth, E., & Little, J. P. (2015). Short-term high-intensity interval and moderate-intensity continuous training reduce leukocyte TLR4 in inactive adults at elevated risk of type 2 diabetes. Journal of Applied Physiology, 119(5), 508–516. https://doi.org/10.1152/japplphysiol.00334.2015
Consitt, L. A., Dudley, C., & Saxena, G. (2019). Impact of endurance and resistance training on skeletal muscle glucose metabolism in older adults. Nutrients, 11(11), 2636. https://doi.org/10.3390/nu11112636
Heiskanen, M. A., Motiani, K. K., Mari, A., Saunavaara, V., Eskelinen, J. J., Virtanen, K. A., Koivumäki, M., Löyttyniemi, E., Nuutila, P., Kalliokoski, K. K., & Hannukainen, J. C. (2018). Exercise training decreases pancreatic fat content and improves beta cell function regardless of baseline glucose tolerance: A randomised controlled trial. Diabetologia, 61(8), 1817–1828. https://doi.org/10.1007/s00125-018-4627-x
Naufahu, J., Elliott, B., Markiv, A., Dunning-Foreman, P., McGrady, M., Howard, D., Watt, P., & Mackenzie, R. W. A. (2018). High-intensity exercise decreases IP6K1 muscle content and improves insulin sensitivity (SI₂*) in glucose-intolerant individuals. The Journal of Clinical Endocrinology & Metabolism, 103(4), 1479–1490. https://doi.org/10.1210/jc.2017-02019
Arrieta-Leandro, M. C., Hernández-Elizondo, J., & Jiménez-Díaz, J. (2023). Effect of chronic high intensity interval training on glycosylated haemoglobin in people with type 2 diabetes: A meta-analysis. Human Movement, 24(1), 32–45. https://doi.org/10.5114/hm.2023.107247
Sjöros, T., Saunavaara, V., Löyttyniemi, E., Koivumäki, M., Heinonen, I. H. A., Eskelinen, J. J., Virtanen, K. A., Hannukainen, J. C., & Kalliokoski, K. K. (2019). Intramyocellular lipid accumulation after sprint interval and moderate-intensity continuous training in healthy and diabetic subjects. Physiological Reports, 7(3), e13980. https://doi.org/10.14814/phy2.13980
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Małgorzata Dorożalska, Małgorzata Jurczyk, Aleksandra Glapa, Weronika Wrona, Wiktoria Wdowiak, Anna Wojdas, Hanna Ludwisiak, Julia Owsik, Maja Cwalina, Weronika Ryś
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Stats
Number of views and downloads: 158
Number of citations: 0
