Comparison of the effects of high-intensity intermittent training and moderate-intensity continuous training on cardiometabolic factors in type 2 diabetic patients: a systematic review and meta-analysis

Lifestyle interventions, including various types of exercise, are considered beneficial in managing type 2 diabetes. This systematic review and meta-analysis aimed at comparing the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on cardiometabolic factors in type 2 diabetes.

A systematic search of English and Farsi papers published in PubMed, Web of Science, Scopus, SID, and Magiran databases was conducted until August 2023. The search utilized keywords such as "high-intensity interval training (HIIT)", "moderate-intensity continuous exercise (MICT)", "cardiometabolic factors", and "type 2 diabetes". A meta-analysis was performed to compare the impact of HIIT and MICT training on cardiometabolic factors in type 2 diabetes. Mean differences and 95% confidence intervals (CI) were calculated using a random-effects model. Heterogeneity was assessed using the I2 test, and publication bias was evaluated through the visual analysis of funnel plots and Egger's test.

Analysis of 10 studies comprising 11 sports interventions involving 271 individuals with type 2 diabetes revealed that HIIT led to a significant reduction in fasting insulin [SMD=-0.93 (-1.25 to -0.6), P=0.001], HOMA-IR [WMD=-0.73 (-1.03 to -0.43), P=0.001], and systolic blood pressure [WMD=-3.15 mmHg (-6.29 to -0.01), P=0.04] compared to MICT in patients with type 2 diabetes. However, there were no significant differences in fasting glucose [WMD=-2.91 mg/dL (-7.97 to 2.14), P=0.2], diastolic blood pressure [WMD=0.3 mmHg (-0.77 to 1.56), P=0.5], and maximum oxygen consumption [SMD=0.49 (-0.004 to 0.99), P=0.05] between HIIT and MICT exercises in patients with type 2 diabetes.

HIIT appears to be a favorable training method with efficient outcomes for improving cardiometabolic factors in patients with type 2 diabetes compared to MICT.