Impact of high-intensity interval training on cardiometabolic health in patients with diabesity: a systematic review and meta-analysis of randomized controlled trials
Sameer Badri Al-Mhanna, Barry A. Franklin, Mark A. Tarnopolsky, John A. Hawley, John M. Jakicic, Emmanuel Stamatakis, Jonathan P. Little, Linda S. Pescatello, Deborah Riebe, W. R. Thompson, James S. Skinner, Sheri R. Colberg, Jonathan K. Ehrman, George S. Metsios, Helen Douda, Norsuhana Omar, Abdullah F. Alghannam, Alexios Batrakoulis
Abstract
AIMS: This systematic review and meta-analysis aimed to evaluate the effects of high-intensity interval training (HIIT) on cardiometabolic health-related outcomes in patients with type 2 diabetes and obesity (diabesity). METHODS: PubMed, Web of Science, Scopus, Science Direct, Cochrane Library, and Google Scholar databases were searched from inception up to November 2024. The search strategy encompassed the following keywords: diabetes, obesity, and HIIT. Randomized controlled trials (RCTs) recruiting adult participants with diabesity and comparing HIIT per se for ≥ 2 weeks in duration with non-exercise standard treatment were included. RESULTS: A total of 18 RCTs qualified involving 504 patients (52/48 women/men ratio; 55.0 ± 11.8 years; 31.0 ± 6.9 kg/m2). Body mass [standardized mean differences (SMD) -0.36 kg, 95% confidence intervals (CI) -0.71 to -0.01], body mass index (SMD -0.57 kg/m2, 95% CI -0.92 to -0.21), waist-to-hip ratio (SMD -1.68, 95% CI -2.50 to -0.86), fasting blood glucose (SMD -0.64 mmol/L, 95% CI -1.03 to -0.24), glycated hemoglobin (SMD -1.08%, 95% CI -1.68 to -0.47), fasting insulin (SMD -0.79 mIU/L, 95% CI -1.28 to -0.31), homeostatic model assessment for insulin resistance (SMD -0.95, 95% CI -1.43 to -0.47), low-density lipoprotein cholesterol (SMD -0.64 mg/dL, 95% CI -1.23 to -0.06), triglycerides (SMD -0.64 mg/dL, 95% CI -1.02 to -0.26), and total cholesterol (SMD -0.66 mg/dL, 95% CI -1.23 to -0.08) improved compared to standard treatment without exercise. CONCLUSIONS: The present findings suggest that HIIT improves several markers of metabolic health and cardiovascular risk, even without significant body composition improvements in patients with diabesity. OPEN SCIENCE FRAMEWORK REGISTRY.: https://osf.io/rtb42.