Effectiveness and safety of high-intensity interval training in patients with type 2 diabetes

Monique E Francois, Jonathan P Little, Monique E Francois, Jonathan P Little

Abstract

IN BRIEF Recent research has shown that high-intensity interval training (HIIT) can promote improvements in glucose control and cardiovascular health in individuals with type 2 diabetes. This article summarizes the evidence and highlights the ways in which HIIT might be safely implemented as an adjunct to more traditional exercise approaches.

Figures

FIGURE 1.
FIGURE 1.
Graphical representation of a typical HIIT protocol. Time is on the horizontal axis and exercise intensity, expressed relative to maximal aerobic capacity (dotted line), is on the vertical axis. The “on” portion of HIIT is typically >70% of maximal aerobic capacity, and these intervals can last from just a few seconds to several minutes. One protocol that has been shown to be feasible, time-efficient, and effective involves 10 × 1 minute at ∼90% maximal aerobic capacity separated by 1-minute rest periods. This protocol is depicted in the figure.
FIGURE 2.
FIGURE 2.
Low-volume HIIT leads to rapid improvements in glucose control in individuals with type 2 diabetes. A: Average 24-hour blood glucose asessed before (Pre) and after (Post) six sessions of HIIT involving 10 × 1 minute at ∼90% of maximal aerobic capacity over 2 weeks. B: A representative 24-hour continuous glucose monitoring curve from a participant assessed under standardized dietary conditions. Reprinted with permission from Ref. .

References

    1. Thompson PD, Crouse SF, Goodpaster B, Kelley D, Moyna N, Pescatello L. The acute versus the chronic response to exercise. Med Sci Sports Exerc 2001;33:S438–S445
    1. Booth FW, Roberts CK, Laye MJ. Lack of exercise is a major cause of chronic diseases. Compr Physiol 2012;2:1143–1211
    1. Paffenbarger RS Jr, Lee I-M. Physical activity and fitness for health and longevity. Res Q Exerc Sport 1996;67:S11–S28
    1. Wei M, Gibbons LW, Kampert JB, Nichaman MZ, Blair SN. Low cardiorespiratory fitness and physical inactivity as predictors of mortality in men with type 2 diabetes. Ann Intern Med 2000;132:605–611
    1. Church TS, Cheng YJ, Earnest CP, et al. . Exercise capacity and body composition as predictors of mortality among men with diabetes. Diabetes Care 2004;27:83–88
    1. Boulé NG, Haddad E, Kenny GP, Wells GA, Sigal RJ. Effects of exercise on glycemic control and body mass in type 2 diabetes mellitus: a meta-analysis of controlled clinical trials. JAMA 2001;286:1218–1227
    1. Sigal RJ, Kenny GP, Wasserman DH, Castaneda-Sceppa C. Physical activity/exercise and type 2 diabetes. Diabetes Care 2004;27:2518–2539
    1. Horowitz JF. Exercise-induced alterations in muscle lipid metabolism improve insulin sensitivity. Exerc Sport Sci Rev 2007;35:192–196
    1. Devlin JT, Hirshman M, Horton ED, Horton ES: Enhanced peripheral and splanchnic insulin sensitivity in NIDDM men after single bout of exercise. Diabetes 1987;36:434–439
    1. Manders RJ, Van Dijk JW, van Loon LJ. Low-intensity exercise reduces the prevalence of hyperglycemia in type 2 diabetes. Med Sci Sports Exerc 2010;42:219–225
    1. Colberg SR, Sigal RJ, Fernhall B, et al. . Exercise and type 2 diabetes: the American College of Sports Medicine and the American Diabetes Association joint position statement. Diabetes Care 2010;33:e147–e167
    1. Bacchi E, Negri C, Targher G, et al. . Both resistance training and aerobic training reduce hepatic fat content in type 2 diabetic subjects with nonalcoholic fatty liver disease (the RAED2 randomized trial). Hepatology 2013;58:1287–1295
    1. van Dijk JW, Manders RJF, Tummers K, et al. . Both resistance-and endurance-type exercise reduce the prevalence of hyperglycaemia in individuals with impaired glucose tolerance and in insulin-treated and non-insulin-treated type 2 diabetic patients. Diabetologia 2011;55:1273–1282
    1. Cuff DJ, Meneilly GS, Martin A, Ignaszewski A, Tildesley HD, Frohlich JJ. Effective exercise modality to reduce insulin resistance in women with type 2 diabetes. Diabetes Care 2003;26:2977–2982
    1. Sigal RJ, Kenny GP, Boulé NG, et al. . Effects of aerobic training, resistance training, or both on glycemic control in type 2 diabetes: a randomized trial. Ann Intern Med 2007;147:357–369
    1. Francois ME, Baldi JC, Manning PJ, et al. . ‘Exercise snacks’ before meals: a novel strategy to improve glycaemic control in individuals with insulin resistance. Diabetologia 2014;57:1437–1445
    1. Helgerud J, Hoydal K, Wang E, et al. . Aerobic high-intensity intervals improve VO2max more than moderate training. Med Sci Sports Exerc 2007;39:665–671
    1. Little JP, Jung ME, Wright AE, Wright W, Manders RJ, Effects of high-intensity interval exercise versus continuous moderate-intensity exercise on postprandial glycemic control assessed by continuous glucose monitoring in obese adults. Appl Physiol Nutr Metab 2014;39:835–841
    1. Tjønna AE, Lee SJ, Rognmo Ø, et al. . Aerobic interval training versus continuous moderate exercise as a treatment for the metabolic syndrome. Circulation 2008;118:346–354
    1. Crespo CJ, Keteyian SJ, Heath GW, Sempos CT. Leisure-time physical activity among US adults: results from the Third National Health and Nutrition Examination Survey. Arch Intern Med 1996;156:93–98
    1. Winett RA, Carpinelli RN. Examining the validity of exercise guidelines for the prevention of morbidity and all-cause mortality. Ann Behav Med 2000;22:237–245
    1. Johnson ST, Boule NG, Bell GJ, Bell RC. Walking: a matter of quantity and quality physical activity for type 2 diabetes management. Appl Physiol Nutr Metab 2008;33:797–801
    1. Kessler HS, Sisson SB, Short KR. The potential for high-intensity interval training to reduce cardiometabolic disease risk. Sports Med 2012;42:489–509
    1. Weston KS, Wisløff U, Coombes JS. High-intensity interval training in patients with lifestyle-induced cardiometabolic disease: a systematic review and meta-analysis. Brit J Sports Med 2014;48:1227–1234
    1. Karstoft K, Winding K, Knudsen SH, et al. . The effects of free-living interval-walking training on glycemic control, body composition, and physical fitness in type 2 diabetic patients: a randomized, controlled trial. Diabetes Care 2013;36:228–236
    1. Nose H, Morikawa M, Yamazaki T, et al. . Beyond epidemiology: field studies and the physiology laboratory as the whole world. J Physiol 2009;587:5569–5575
    1. Praet SFE, Jonkers RAM, Schep G, et al. . Long-standing, insulin-treated type 2 diabetes patients with complications respond well to short-term resistance and interval exercise training. Eur J Endocrinol 2008;158:163–172
    1. Trost SG, Owen N, Bauman AE, Sallis JF, Brown W. Correlates of adults’ participation in physical activity: review and update. Med Sci Sports Exerc 2002;34:1996–2001
    1. Little JP, Gillen JB, Percival M, et al. . Low-volume high-intensity interval training reduces hyperglycemia and increases muscle mitochondrial capacity in patients with type 2 diabetes. J Appl Physiol 2011;111:1554–1560
    1. Shaban N, Kenno K, Milne K. The effects of a 2 week modified high intensity interval training program on the homeostatic model of insulin resistance (HOMA-IR) in adults with type 2 diabetes. J Sports Medicine Phys Fitness 2014;54:203–209
    1. Mitranun W, Deerochanawong C, Tanaka H, Suksom D. Continuous vs interval training on glycemic control and macro‐and microvascular reactivity in type 2 diabetic patients. Scand J Med Sci Sports 2014;24:69–76
    1. Gillen JB, Little JP, Punthakee Z, Tarnopolsky MA, Riddell MC, Gibala MJ. Acute high-intensity interval exercise reduces the postprandial glucose response and prevalence of hyperglycaemia in patients with type 2 diabetes. Diabetes Obes Metab 2012;14:575–577
    1. Terada T, Friesen A, Chahal BS, Bell GJ, McCargar LJ, Boule NG. Exploring the variability in acute glycemic responses to exercise in type 2 diabetes. J Diabetes Res 2013;2013:591574.
    1. Roberts CK, Little JP, Thyfault JP. Modification of insulin sensitivity and glycemic control by activity and exercise. Med Sci Sports Exerc 2013;45:1868–1877
    1. Boutcher SH: High-intensity intermittent exercise and fat loss. J Obes 2011;2011:868305.
    1. Gillen JB, Percival ME, Ludzki A, Tarnopolsky MA, Gibala M. Interval training in the fed or fasted state improves body composition and muscle oxidative capacity in overweight women. Obesity 2013;21:2249–2255
    1. Metcalfe RS, Babraj JA, Fawkner SG, Vollaard NB. Towards the minimal amount of exercise for improving metabolic health: beneficial effects of reduced-exertion high-intensity interval training. Eur J Appl Physiol 2012;112:2767–2775
    1. Rognmo Ø, Moholdt T, Bakken H, et al. . Cardiovascular risk of high- versus moderate-intensity aerobic exercise in coronary heart disease patients. Circulation 2012;126:1436–1440
    1. Thompson PD. The cardiovascular complications of vigorous physical activity. Arch Intern Med 1996;156:2297–2302
    1. Borg GA: Psychophysical basis of perceived exertion. Med Sci Sports Exerc 1982;14:377–381

Source: PubMed

3
订阅