PMID 41370222

Research
All papers

Comparative effects of combined aerobic and resistance training versus high-intensity interval training on insulin resistance, glycaemic control, body composition and quality of life in type 2 diabetes: A 12-week randomised controlled trial

Amaravadi SK, Ferreira AS, Vigário PDS

Question

Do 12 weeks of combined aerobic-resistance training or HIIT improve insulin resistance, glycaemic control, body composition, functional capacity, and quality of life in adults with type 2 diabetes compared with standard care?

Summary

In 90 adults with type 2 diabetes, 12 weeks of structured exercise improved metabolic, body composition, walking, activity, and quality-of-life outcomes compared with usual care. HIIT used progressive interval walking with heart-rate and RPE monitoring; combined aerobic-resistance training produced similar broad benefits, with no adverse events reported.

Methodology

  • Adults aged 30-65 years with type 2 diabetes
  • 90 participants.
  • Walking intervals.
  • Work intervals: 1 minute at 85-90% peak heart rate or RPE 7-8/10.
  • Recovery: 1 minute active recovery at RPE 3-4/10.
  • Intensity: 85-90% peak heart rate; RPE guided.
  • 40-65 minutes including warm-up and cool-down.
  • 3-5 sessions per week.
  • 12 weeks.
  • Single-centre randomized controlled trial
  • Fasting glucose, HbA1c, HOMA-IR, and Six-minute walk distance were tracked.

Outcomes

Fasting glucose

HIIT reduced fasting glucose versus control more than A+R numerically.

HIIT MD -29.09 mg/dL, 95% CI -41.16 to -17.02; A+R MD -20.59 mg/dL, 95% CI -30.96 to -10.21.

Improved

HbA1c

Both active interventions lowered HbA1c versus control.

HIIT MD -3.35%, 95% CI -4.11 to -2.58; A+R MD -3.33%, 95% CI -4.03 to -2.62.

Improved

HOMA-IR

A+R improved HOMA-IR versus control; HIIT had a non-significant trend.

A+R MD -2.33, 95% CI -3.63 to -1.03; HIIT MD -1.17, 95% CI -2.47 to 0.13.

Mixed

6MWD

Both active groups increased six-minute walk distance versus control, with larger gain for A+R.

HIIT MD +178.91 m, 95% CI 130.47 to 227.35; A+R MD +233.61 m, 95% CI 191.75 to 275.47.

Improved

Body fat

Both interventions decreased subcutaneous and visceral fat and increased fat-free mass versus control.

Subcutaneous fat: HIIT MD -7.16%, A+R MD -8.37%; visceral fat: HIIT MD -4.70%, A+R MD -4.58%; fat-free mass: HIIT MD +7.54 kg, A+R MD +5.96 kg.

Improved

Safety

No adverse events were reported by participants in either intervention group.

No clear change

Insights

  • Walking-based HIIT can be adapted for T2DM using submaximal high-intensity targets and active recovery.
  • Use RPE and heart rate together when translating clinical HIIT protocols.
  • For diabetes content, include stop rules and hypoglycaemia cautions.

Limitations

  • 12-week duration with no long-term follow-up
  • Findings limited to adherent participants without advanced complications
  • Dietary intake, sleep, medication changes, and outside activity were not systematically controlled
  • Bioelectrical impedance may affect body-composition estimates

Safety

  • No adverse events were reported in either intervention group.
  • Participants were told to recognize hypoglycaemia and exercise termination signs such as chest pain or shortness of breath.