The Effects of high intensity training on glycated hemoglobin type A1C reduction and insulin resistance changes compared to moderate intensity training in patients with type 2 diabetes : a systematic review and meta analysis

Effects of HIT on glycated hemoglobin A1C and IR

Authors

  • Sonia Elvira Salim Udayana University
  • I Made Fermi Wikananda
  • Dewi Catur Wulandari
  • I Gde Raka Widiana

DOI:

https://doi.org/10.59747/smjidisurabaya.v1i2.33

Abstract

Background: In most of the type 2 Diabetes management recommends lifestyle   including physical activity. Several studies have examined the effects of HIT and MIT on the glycated Hemoglobin type A1C (HbA1c) and Insulin resistance reduction in type 2 Diabetes. Objective: The objective of this meta-analysis was to investigate the impacts of high and moderate intensity training to reducing HbA1C and changes insulin resistance in type 2 Diabetes Melitus patient.State the objectives of the research. Material and Method: We searched the online databases of PubMed, ScienceDirect, and Cochrane Library for relevant studies evaluating the effects of High Intensity Training on T2DM patients. Using random effects model, comparing Mean Difference and standard deviation with 95% confidence internal (CI) were used to investigate the studies.Conclusion: In this study we found that HIT showed significantly better result to reduced HbA1C. HIT improves glucose control center’s ability to recruit more muscle fibers and depleting muscle glycogen levels compared to MIT, HIT does not significantly reduce insulin resistance compared to MIT.

References

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Ali, S., Athar, M., Ahmed, S.M., 2019. Basics of CPB. Indian J. Anaesth. 49, 257–262.

Amanat, S., Ghahri, S., Dianatinasab, A., Fararouei, M., Dianatinasab, M., 2020. Exercise and Type 2 Diabetes. Adv. Exp. Med. Biol. 1228, 91–105.

Cho, N.H., Shaw, J.E., Karuranga, S., Huang, Y., da Rocha Fernandes, J.D., Ohlrogge, A.W., Malanda, B., 2018. IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Res. Clin. Pract. 138, 271–281.

Chung, I.M., Rajakumar, G., Subramanian, U., Venkidasamy, B., Khanna, V.G., Thiruvengadam, M., 2020. Insights on the current status and advancement of diabetes mellitus type 2 and to avert complications: An overview, Biotechnology and Applied Biochemistry.

Colberg, S.R., Sigal, R.J., Yardley, J.E., Riddell, M.C., Dunstan, D.W., Dempsey, P.C., Horton, E.S., Castorino, K., Tate, D.F., 2016. Physical activity/exercise and diabetes: A position statement of the American Diabetes Association. Diabetes Care 39, 2065–2079.

Dasso, N.A., 2019. How is exercise different from physical activity? A concept analysis. Nurs. Forum 54, 45–52.

Dunstan, D., Daly, R., Owen, N., Jolley, D., Vulikh, E., Shaw, J., Zimmet, P., 2005. Home-based resistance training is not sufficient to maintain improved glycemic control following supervised training in older individuals with type 2 diabetes. Diabetes Care 28, 3–9.

Gentil, P., Silva, L.R.B. e., Antunes, D.E., Carneiro, L.B., de Lira, C.A.B., Batista, G., Oliveira, J.C.M. de, Cardoso, J.S., Souza, D.C.C., Rebelo, A.C.S., 2023. The effects of three different low-volume aerobic training protocols on cardiometabolic parameters of type 2 diabetes patients: A randomized clinical trial. Front. Endocrinol. (Lausanne). 14, 1–9.

Hansen, D., Dendale, P., Jonkers, R.A.M., Beelen, M., Manders, R.J.F., Corluy, L., Mullens, A., Berger, J., Meeusen, R., Van Loon, L.J.C., 2009. Continuous low- to moderate-intensity exercise training is as effective as moderate- to high-intensity exercise training at lowering blood HbA1c in obese type 2 diabetes patients. Diabetologia 52, 1789–1797.

Hollekim-Strand, S.M., Bjørgaas, M.R., Albrektsen, G., Tjønna, A.E., Wisløff, U., Ingul, C.B., 2014. High-intensity interval exercise effectively improves cardiac function in patients with type 2 diabetes mellitus and diastolic dysfunction: A randomized controlled trial. J. Am. Coll. Cardiol. 64, 1758–1760.

Hwang, C.L., Lim, J., Yoo, J.K., Kim, H.K., Hwang, M.H., Handberg, E.M., Petersen, J.W., Holmer, B.J., Leey Casella, J.A., Cusi, K., Christou, D.D., 2019. Effect of all-extremity high-intensity interval training vs. moderate-intensity continuous training on aerobic fitness in middle-aged and older adults with type 2 diabetes: A randomized controlled trial. Exp. Gerontol. 116, 46–53.

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Kirwan, J.P., Sacks, J., Nieuwoudt, S., 2017. The essential role of exercise in the management of type 2 diabetes. Cleve. Clin. J. Med. 84, S15–S21.

Kumar, A., Maiya, A., Shastry, B., Vaishali, K., Ravishankar, N., Hazari, A., Gundmi, S., Jadhav, R., 2019. Exercise and insulin resistance in type 2 diabetes mellitus: A systematic review and meta-analysis. Ann. Phys. Rehabil. Med. 62, 98–103.

Maillard, F., Rousset, S., Pereira, B., Traore, A., de Pradel Del Amaze, P., Boirie, Y., Duclos, M., Boisseau, N., 2016. High-intensity interval training reduces abdominal fat mass in postmenopausal women with type 2 diabetes. Diabetes Metab. 42, 433–441.

Manz, K., Krug, S., 2013. Physical activity and health. Public Heal. Forum 21.

Mulla, N.A.L., Simonsen, L., Bülow, J., 2000. Post-exercise adipose tissue and skeletal muscle lipid metabolism in humans: The effects of exercise intensity. J. Physiol. 524, 919–928.

Najafipour, F., Mobasseri, M., Yavari, A., Nadrian, H., Aliasgarzadeh, A., Abbasi, N.M., Niafar, M., Gharamaleki, J.H., Sadra, V., 2017. Effect of regular exercise training on changes in HbA1c, BMI and VO 2 max among patients with type 2 diabetes mellitus: An 8-year trial. BMJ Open Diabetes Res. Care 5, 1–7.

Park, J.H., Lee, Y.E., 2015. Effects of exercise on glycemic control in type 2 diabetes mellitus in Koreans: The fifth Korea National Health and Nutrition Examination Survey (KNHANES V). J. Phys. Ther. Sci. 27, 3559–3564.

Pedrosa, A., Furtado, G., de Barros, M.P., Bachi, A.L.L., Ferreira, J.P., Sardão, V.A., Rama, L., Teixeira, A., 2023. The Impact of Moderate-to-High-Intensity Exercise Protocols on Glycated Hemoglobin Levels in Type 2 Diabetes Patients. Diabetology 4, 11–18.

Petersen, M.C., Shulman, G.I., 2018. Mechanisms of insulin action and insulin resistance. Physiol. Rev. 98, 2133–2223.

Sami, W., Ansari, T., Butt, N.S., Rashid, M., Hamid, A., 2017. Effect Of Diet Counseling on Type 2 Diabetes Mellitus: A Review. Int. J. Health Sci. (Qassim). 11, 65–71.

Schnurr, T.M., Reynolds, A.J., Komac, A.M., Duffy, L.K., Dunlap, K.L., 2015. The effect of acute exercise on GLUT4 levels in peripheral blood mononuclear cells of sled dogs. Biochem. Biophys. Reports 2, 45–49.

Simmonds, M., 2015. Quantifying the risk of error when interpreting funnel plots. Syst. Rev. 4, 1–7.

Stoa, E.M., 2017. The Effect of Training Intensity , Age and Diet on Aerobic Capacity and Metabolic Risk Factors. Southeast Norway.

Støa, E.M., Meling, S., Nyhus, L.K., Glenn Strømstad, Mangerud, K.M., Helgerud, J., Bratland-Sanda, S., Støren, Ø., 2017. High-intensity aerobic interval training improves aerobic fitness and HbA1c among persons diagnosed with type 2 diabetes. Eur. J. Appl. Physiol. 117, 455–467.

Syeda, U.S.A., Battillo, D., Visaria, A., Malin, S.K., 2023. The importance of exercise for glycemic control in type 2 diabetes. Am. J. Med. Open 9, 100031.

Terada, T., Friesen, A., Chahal, B.S., Bell, G.J., McCargar, L.J., Boulé, N.G., 2013. Feasibility and preliminary efficacy of high intensity interval training in type 2 diabetes. Diabetes Res. Clin. Pract. 99, 120–129.

Van Dijk, J.W., Van Loon, L.J.C., 2015. Exercise strategies to optimize glycemic control in type 2 diabetes: A continuing glucose monitoring perspective. Diabetes Spectr. 28, 24–31.

WHO and IDF, 2020. Diagnosis and management of type 2 diabetes. World Health Organization, Geneva, Switzerland.

Yun, I., Joo, H.J., Park, Y.S., Park, E.C., 2022. Association between Physical Exercise and Glycated Hemoglobin Levels in Korean Patients Diagnosed with Diabetes. Int. J. Environ. Res. Public Health 19.

Abdelbasset, W.K., Tantawy, S.A., Kamel, D.M., Alqahtani, B.A., Elnegamy, T.E., Soliman, G.S., Ibrahim, A.A., 2020. Effects of high-intensity interval and moderate-intensity continuous aerobic exercise on diabetic obese patients with nonalcoholic fatty liver disease: A comparative randomized controlled trial. Med. (United States) 99, E19471.

Ali, S., Athar, M., Ahmed, S.M., 2019. Basics of CPB. Indian J. Anaesth. 49, 257–262.

Amanat, S., Ghahri, S., Dianatinasab, A., Fararouei, M., Dianatinasab, M., 2020. Exercise and Type 2 Diabetes. Adv. Exp. Med. Biol. 1228, 91–105.

Cho, N.H., Shaw, J.E., Karuranga, S., Huang, Y., da Rocha Fernandes, J.D., Ohlrogge, A.W., Malanda, B., 2018. IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Res. Clin. Pract. 138, 271–281.

Chung, I.M., Rajakumar, G., Subramanian, U., Venkidasamy, B., Khanna, V.G., Thiruvengadam, M., 2020. Insights on the current status and advancement of diabetes mellitus type 2 and to avert complications: An overview, Biotechnology and Applied Biochemistry.

Colberg, S.R., Sigal, R.J., Yardley, J.E., Riddell, M.C., Dunstan, D.W., Dempsey, P.C., Horton, E.S., Castorino, K., Tate, D.F., 2016. Physical activity/exercise and diabetes: A position statement of the American Diabetes Association. Diabetes Care 39, 2065–2079.

Dasso, N.A., 2019. How is exercise different from physical activity? A concept analysis. Nurs. Forum 54, 45–52.

Dunstan, D., Daly, R., Owen, N., Jolley, D., Vulikh, E., Shaw, J., Zimmet, P., 2005. Home-based resistance training is not sufficient to maintain improved glycemic control following supervised training in older individuals with type 2 diabetes. Diabetes Care 28, 3–9.

Gentil, P., Silva, L.R.B. e., Antunes, D.E., Carneiro, L.B., de Lira, C.A.B., Batista, G., Oliveira, J.C.M. de, Cardoso, J.S., Souza, D.C.C., Rebelo, A.C.S., 2023. The effects of three different low-volume aerobic training protocols on cardiometabolic parameters of type 2 diabetes patients: A randomized clinical trial. Front. Endocrinol. (Lausanne). 14, 1–9.

Hansen, D., Dendale, P., Jonkers, R.A.M., Beelen, M., Manders, R.J.F., Corluy, L., Mullens, A., Berger, J., Meeusen, R., Van Loon, L.J.C., 2009. Continuous low- to moderate-intensity exercise training is as effective as moderate- to high-intensity exercise training at lowering blood HbA1c in obese type 2 diabetes patients. Diabetologia 52, 1789–1797.

Hollekim-Strand, S.M., Bjørgaas, M.R., Albrektsen, G., Tjønna, A.E., Wisløff, U., Ingul, C.B., 2014. High-intensity interval exercise effectively improves cardiac function in patients with type 2 diabetes mellitus and diastolic dysfunction: A randomized controlled trial. J. Am. Coll. Cardiol. 64, 1758–1760.

Hwang, C.L., Lim, J., Yoo, J.K., Kim, H.K., Hwang, M.H., Handberg, E.M., Petersen, J.W., Holmer, B.J., Leey Casella, J.A., Cusi, K., Christou, D.D., 2019. Effect of all-extremity high-intensity interval training vs. moderate-intensity continuous training on aerobic fitness in middle-aged and older adults with type 2 diabetes: A randomized controlled trial. Exp. Gerontol. 116, 46–53.

International Diabetes Federation, 2021. IDF Diabetes Atlas, 10th editi. ed, Diabetes Research and Clinical Practice. International Diabetes Federation, Brussels.

Kirwan, J.P., Sacks, J., Nieuwoudt, S., 2017. The essential role of exercise in the management of type 2 diabetes. Cleve. Clin. J. Med. 84, S15–S21.

Kumar, A., Maiya, A., Shastry, B., Vaishali, K., Ravishankar, N., Hazari, A., Gundmi, S., Jadhav, R., 2019. Exercise and insulin resistance in type 2 diabetes mellitus: A systematic review and meta-analysis. Ann. Phys. Rehabil. Med. 62, 98–103.

Maillard, F., Rousset, S., Pereira, B., Traore, A., de Pradel Del Amaze, P., Boirie, Y., Duclos, M., Boisseau, N., 2016. High-intensity interval training reduces abdominal fat mass in postmenopausal women with type 2 diabetes. Diabetes Metab. 42, 433–441.

Manz, K., Krug, S., 2013. Physical activity and health. Public Heal. Forum 21.

Mulla, N.A.L., Simonsen, L., Bülow, J., 2000. Post-exercise adipose tissue and skeletal muscle lipid metabolism in humans: The effects of exercise intensity. J. Physiol. 524, 919–928.

Najafipour, F., Mobasseri, M., Yavari, A., Nadrian, H., Aliasgarzadeh, A., Abbasi, N.M., Niafar, M., Gharamaleki, J.H., Sadra, V., 2017. Effect of regular exercise training on changes in HbA1c, BMI and VO 2 max among patients with type 2 diabetes mellitus: An 8-year trial. BMJ Open Diabetes Res. Care 5, 1–7.

Park, J.H., Lee, Y.E., 2015. Effects of exercise on glycemic control in type 2 diabetes mellitus in Koreans: The fifth Korea National Health and Nutrition Examination Survey (KNHANES V). J. Phys. Ther. Sci. 27, 3559–3564.

Pedrosa, A., Furtado, G., de Barros, M.P., Bachi, A.L.L., Ferreira, J.P., Sardão, V.A., Rama, L., Teixeira, A., 2023. The Impact of Moderate-to-High-Intensity Exercise Protocols on Glycated Hemoglobin Levels in Type 2 Diabetes Patients. Diabetology 4, 11–18.

Petersen, M.C., Shulman, G.I., 2018. Mechanisms of insulin action and insulin resistance. Physiol. Rev. 98, 2133–2223.

Sami, W., Ansari, T., Butt, N.S., Rashid, M., Hamid, A., 2017. Effect Of Diet Counseling on Type 2 Diabetes Mellitus: A Review. Int. J. Health Sci. (Qassim). 11, 65–71.

Schnurr, T.M., Reynolds, A.J., Komac, A.M., Duffy, L.K., Dunlap, K.L., 2015. The effect of acute exercise on GLUT4 levels in peripheral blood mononuclear cells of sled dogs. Biochem. Biophys. Reports 2, 45–49.

Simmonds, M., 2015. Quantifying the risk of error when interpreting funnel plots. Syst. Rev. 4, 1–7.

Stoa, E.M., 2017. The Effect of Training Intensity , Age and Diet on Aerobic Capacity and Metabolic Risk Factors. Southeast Norway.

Støa, E.M., Meling, S., Nyhus, L.K., Glenn Strømstad, Mangerud, K.M., Helgerud, J., Bratland-Sanda, S., Støren, Ø., 2017. High-intensity aerobic interval training improves aerobic fitness and HbA1c among persons diagnosed with type 2 diabetes. Eur. J. Appl. Physiol. 117, 455–467.

Syeda, U.S.A., Battillo, D., Visaria, A., Malin, S.K., 2023. The importance of exercise for glycemic control in type 2 diabetes. Am. J. Med. Open 9, 100031.

Terada, T., Friesen, A., Chahal, B.S., Bell, G.J., McCargar, L.J., Boulé, N.G., 2013. Feasibility and preliminary efficacy of high intensity interval training in type 2 diabetes. Diabetes Res. Clin. Pract. 99, 120–129.

Van Dijk, J.W., Van Loon, L.J.C., 2015. Exercise strategies to optimize glycemic control in type 2 diabetes: A continuing glucose monitoring perspective. Diabetes Spectr. 28, 24–31.

WHO and IDF, 2020. Diagnosis and management of type 2 diabetes. World Health Organization, Geneva, Switzerland.

Yun, I., Joo, H.J., Park, Y.S., Park, E.C., 2022. Association between Physical Exercise and Glycated Hemoglobin Levels in Korean Patients Diagnosed with Diabetes. Int. J. Environ. Res. Public Health 19.

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Published

2023-11-10

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Scoping review/ systematic review/ meta-analysis

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