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
Abstract Objective To evaluate the effects of high-intensity interval training (HIIT) on cardiometabolic health-related outcomes in patients with type 2 diabetes mellitus and concurrent overweight/obesity (diabesity). Design Systematic review and meta-analysis of randomized controlled trials (RCTs)....
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BMC
2025-08-01
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| Series: | Diabetology & Metabolic Syndrome |
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| Online Access: | https://doi.org/10.1186/s13098-025-01909-z |
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| author | Sameer Badri Al-Mhanna Eric Tsz-Chun Poon Barry A. Franklin Mark A. Tarnopolsky John A. Hawley John M. Jakicic Emmanuel Stamatakis Jonathan P. Little Linda S. Pescatello Deborah Riebe Walter R. Thompson James S. Skinner Sheri R. Colberg Jonathan K. Ehrman George S. Metsios Helen T. Douda Norsuhana Omar Abdullah F. Alghannam Alexios Batrakoulis |
| author_facet | Sameer Badri Al-Mhanna Eric Tsz-Chun Poon Barry A. Franklin Mark A. Tarnopolsky John A. Hawley John M. Jakicic Emmanuel Stamatakis Jonathan P. Little Linda S. Pescatello Deborah Riebe Walter R. Thompson James S. Skinner Sheri R. Colberg Jonathan K. Ehrman George S. Metsios Helen T. Douda Norsuhana Omar Abdullah F. Alghannam Alexios Batrakoulis |
| author_sort | Sameer Badri Al-Mhanna |
| collection | DOAJ |
| description | Abstract Objective To evaluate the effects of high-intensity interval training (HIIT) on cardiometabolic health-related outcomes in patients with type 2 diabetes mellitus and concurrent overweight/obesity (diabesity). Design Systematic review and meta-analysis of randomized controlled trials (RCTs). Data sources PubMed, Web of Science, Scopus, Science Direct, Cochrane Library, and Google Scholar databases were searched from inception up to January 31, 2025. Eligibility criteria for selecting studies RCTs comparing HIIT alone ≥ 2 weeks in duration with moderate-intensity continuous training (MICT). Participants were adults with diabesity. Results A total of 26 RCTs qualified, involving 790 patients (50/50 female/male ratio; age: 59.8 ± 12.9 years; body mass index: 28.9 ± 4.2 kg/m2). HIIT revealed a significant reduction in fasting insulin [standardized mean differences (SMD) − 0.43, 95% CI − 0.82 to − 0.05] and homeostatic model assessment for insulin resistance (HOMA-IR; SMD − 0.52, 95% CI − 0.97 to − 0.07) compared to MICT. Additionally, HIIT significantly increased cardiorespiratory fitness (VO₂max; SMD 0.53, 95% CI 0.14 to 0.91) compared to MICT. Other clinically relevant cardiometabolic outcomes, including body composition, lipid profile, fasting blood glucose, glycated hemoglobin, and blood pressure, showed comparable changes between HIIT and MICT. Subgroup analyses of studies reporting comorbidities indicated a significant increase in high-density lipoprotein cholesterol (SMD 0.49, 95% CI 0.04 to 0.95) and a decrease in HOMA-IR (SMD − 0.83, 95% CI − 1.62 to − 0.04) for HIIT compared to MICT. However, these findings are limited by very low certainty evidence and non-robust sensitivity analyses. Conclusions The present findings suggest that HIIT may serve as an adjunctive non-pharmaceutical management solution for patients with diabesity. Open Science Framework registry: https://osf.io/9by24 |
| format | Article |
| id | doaj-art-c163062b6a264d52b86a4bd7d3e8d1a9 |
| institution | Kabale University |
| issn | 1758-5996 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Diabetology & Metabolic Syndrome |
| spelling | doaj-art-c163062b6a264d52b86a4bd7d3e8d1a92025-08-20T03:46:23ZengBMCDiabetology & Metabolic Syndrome1758-59962025-08-0117112010.1186/s13098-025-01909-zComparative 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 trialsSameer Badri Al-Mhanna0Eric Tsz-Chun Poon1Barry A. Franklin2Mark A. Tarnopolsky3John A. Hawley4John M. Jakicic5Emmanuel Stamatakis6Jonathan P. Little7Linda S. Pescatello8Deborah Riebe9Walter R. Thompson10James S. Skinner11Sheri R. Colberg12Jonathan K. Ehrman13George S. Metsios14Helen T. Douda15Norsuhana Omar16Abdullah F. Alghannam17Alexios Batrakoulis18Center for Global Health Research, Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical SciencesDepartment of Sports Science and Physical Education, The Chinese University of Hong KongPreventive Cardiology and Cardiac Rehabilitation, Corewell Health William Beaumont University HospitalDepartment of Pediatrics, McMaster UniversityExercise and Nutrition Research Program, The Mary MacKillop Institute for Health Research, Australian Catholic UniversityDepartment of Internal Medicine, Division of Physical Activity and Weight Management, Medical Center, University of KansasMackenzie Wearables Research Hub, Charles Perkins Centre, The University of SydneySchool of Health and Exercise Sciences, University of British ColumbiaDepartment of Kinesiology, University of ConnecticutCollege of Health Sciences, University of Rhode IslandCollege of Education and Human Development, Georgia State UniversityDepartment of Kinesiology, Indiana University BloomingtonHuman Movement Sciences Department, Old Dominion UniversityDivision of Cardiovascular Medicine, Department of Medicine, Henry Ford HealthDepartment of Nutrition and Dietetics, University of ThessalyDepartment of Physical Education and Sport Science, School of Physical Education, Sport Science and Occupational Therapy, Democritus University of ThraceDepartment of Physiology, School of Medical Sciences, Universiti Sains MalaysiaLifestyle and Health Research Center, Health Sciences Research Center, Princess Nourah Bint Abdulrahman, UniversityDepartment of Physical Education and Sport Science, School of Physical Education, Sport Science and Occupational Therapy, Democritus University of ThraceAbstract Objective To evaluate the effects of high-intensity interval training (HIIT) on cardiometabolic health-related outcomes in patients with type 2 diabetes mellitus and concurrent overweight/obesity (diabesity). Design Systematic review and meta-analysis of randomized controlled trials (RCTs). Data sources PubMed, Web of Science, Scopus, Science Direct, Cochrane Library, and Google Scholar databases were searched from inception up to January 31, 2025. Eligibility criteria for selecting studies RCTs comparing HIIT alone ≥ 2 weeks in duration with moderate-intensity continuous training (MICT). Participants were adults with diabesity. Results A total of 26 RCTs qualified, involving 790 patients (50/50 female/male ratio; age: 59.8 ± 12.9 years; body mass index: 28.9 ± 4.2 kg/m2). HIIT revealed a significant reduction in fasting insulin [standardized mean differences (SMD) − 0.43, 95% CI − 0.82 to − 0.05] and homeostatic model assessment for insulin resistance (HOMA-IR; SMD − 0.52, 95% CI − 0.97 to − 0.07) compared to MICT. Additionally, HIIT significantly increased cardiorespiratory fitness (VO₂max; SMD 0.53, 95% CI 0.14 to 0.91) compared to MICT. Other clinically relevant cardiometabolic outcomes, including body composition, lipid profile, fasting blood glucose, glycated hemoglobin, and blood pressure, showed comparable changes between HIIT and MICT. Subgroup analyses of studies reporting comorbidities indicated a significant increase in high-density lipoprotein cholesterol (SMD 0.49, 95% CI 0.04 to 0.95) and a decrease in HOMA-IR (SMD − 0.83, 95% CI − 1.62 to − 0.04) for HIIT compared to MICT. However, these findings are limited by very low certainty evidence and non-robust sensitivity analyses. Conclusions The present findings suggest that HIIT may serve as an adjunctive non-pharmaceutical management solution for patients with diabesity. Open Science Framework registry: https://osf.io/9by24https://doi.org/10.1186/s13098-025-01909-zExerciseIntermittent trainingMetabolic syndromeBody compositionBlood pressureGlucose metabolism |
| spellingShingle | Sameer Badri Al-Mhanna Eric Tsz-Chun Poon Barry A. Franklin Mark A. Tarnopolsky John A. Hawley John M. Jakicic Emmanuel Stamatakis Jonathan P. Little Linda S. Pescatello Deborah Riebe Walter R. Thompson James S. Skinner Sheri R. Colberg Jonathan K. Ehrman George S. Metsios Helen T. Douda Norsuhana Omar Abdullah F. Alghannam Alexios Batrakoulis 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 Exercise Intermittent training Metabolic syndrome Body composition Blood pressure Glucose metabolism |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | Exercise Intermittent training Metabolic syndrome Body composition Blood pressure Glucose metabolism |
| url | https://doi.org/10.1186/s13098-025-01909-z |
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