The Effect of Traditional Aerobic Exercise and Sprint Interval Training on Insulin Resistance in Men With Prediabetes: A Randomised Controlled Trial
Question
Does 3 months of field-based sprint interval training improve insulin resistance in men with prediabetes similarly to traditional brisk-walking aerobic exercise?
Summary
In 160 men with prediabetes randomized to 3 months of brisk walking or sprint interval training, both exercise programs significantly reduced HOMA-IR and improved HbA1c, fasting glucose, fasting insulin, BMI, and waist-hip ratio. SIT required much less weekly exercise time and was not statistically superior to traditional aerobic exercise for HOMA-IR. One SIT participant withdrew after knee pain and one aerobic exercise participant withdrew after a sprain; no other adverse events were reported.
Methodology
- 160 asymptomatic men aged 25-40 with prediabetes randomized 1:1 to aerobic exercise or SIT; 146 completed post-intervention testing.
- 160 participants.
- All-out running.
- Work intervals: 1 min all-out run effort.
- Recovery: 1.5 min recovery rest.
- Intensity: All-out effort.
- 10 min main session plus 5-min warm-up and post-session stretching.
- 3 sessions/week.
- 3 months.
- Parallel-group randomized controlled trial
- Insulin resistance, Glycemic and anthropometric secondary outcomes, and Adverse events were tracked.
Outcomes
HOMA-IR per-protocol
Both AE and SIT significantly reduced HOMA-IR.
AE 3.6 +/- 1.1 to 3.0 +/- 1.2, p<0.0001; SIT 3.3 +/- 1.2 to 2.5 +/- 1.0, p<0.0001
Between-group HOMA-IR change
The HOMA-IR change did not differ significantly between SIT and AE.
Per-protocol change AE -0.6 +/- 1.1 vs SIT -0.8 +/- 1.6, between-group p=0.445; ITT p=0.403
Secondary metabolic and anthropometric outcomes
HbA1c, fasting glucose, fasting insulin, BMI, and waist-hip ratio improved in both groups.
Within-group p values generally <0.0001 except SIT insulin p=0.001; between-group differences were not significant except WHR p=0.001 with approximately 1% mean difference
Safety
One participant in each group withdrew after a musculoskeletal event; no other adverse events were reported.
SIT: one knee pain withdrawal; AE: one sprain withdrawal
Insights
- Short all-out SIT may be a time-efficient alternative to 150 min/week brisk walking for screened men with prediabetes.
- Because all-out running is joint-stressful and intensity was subjective, low-impact or monitored alternatives may be safer for app translation.
- Benefits were similar, not superior, to traditional aerobic exercise for HOMA-IR.
Limitations
- Men only.
- No non-exercise control group.
- Dietary and other lifestyle factors were not recorded.
- All-out effort was subjective and not objectively verified.
- Only fasting-status insulin sensitivity was assessed.
- Single-region/single-center context and 3-month duration.
Safety
- One SIT participant could not complete because of knee pain that subsided over a week but did not return. One AE participant withdrew after a sprain. No other adverse events were reported.