Functional high-intensity exercise training ameliorates insulin resistance and cardiometabolic risk factors in type 2 diabetes.
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New Findings What is the central question of this study? Does short‐duration, high‐intensity exercise training that combines functional aerobic and resistance exercises into training sessions lasting 8–20 min benefit individuals with type 2 diabetes? What is the main finding and its importance? Functional high‐intensity training improves insulin sensitivity and reduces cardiometabolic risk in individuals with type 2 diabetes. This type of exercise training may be an effective exercise mode for managing type 2 diabetes. The increase in insulin sensitivity addresses a key defect in type 2 diabetes. Abstract Functional high‐intensity training (F‐HIT) is a novel fitness paradigm that integrates simultaneous aerobic and resistance training in sets of constantly varied movements, based on real‐world situational exercises, performed at high‐intensity in workouts that range from ∼8 to 20 min per session. We hypothesized that F‐HIT would be an effective exercise mode for reducing insulin resistance in type 2 diabetes (T2D). We recruited 13 overweight/obese adults (5 males, 8 females; 53 ± 7 years; BMI 34.5 ± 3.6 kg m−2, means ± SD) with T2D to participate in a 6‐week (3 days week−1) supervised F‐HIT programme. An oral glucose tolerance test was used to derive measures of insulin sensitivity. F‐HIT significantly reduced fat mass (43.8 ± 83.8 vs. 41.6 ± 7.9 kg;P < 0.01), diastolic blood pressure (80.2 ± 7.1 vs. 74.5 ± 5.8;P < 0.01), blood lipids (triglyceride and VLDL, bothP < 0.05) and metabolic syndromez‐score (6.4 ± 4.5 vs. ‐0.2 ± 5.2 AU;P < 0.001), and increased basal fat oxidation (0.08 ± 0.03 vs. 0.10 ± 0.04 g min−1;P = 0.05), and high molecular mass adiponectin (214.4 ± 88.9 vs. 288.8 ± 127.4 ng mL−1;P < 0.01). Importantly, F‐HIT also increased insulin sensitivity (0.037 ± 0.010 vs. 0.042 ± 0.010 AU;P < 0.05). Increases in high molecular mass adiponectin and basal fat oxidation correlated with the change in insulin sensitivity (ρ, 0.75,P < 0.05 and ρ, 0.81,P < 0.01, respectively). Compliance with the training programme was >95% and no injuries or adverse events were reported. These data suggest that F‐HIT may be an effective exercise mode for managing T2D. The increase in insulin sensitivity addresses a key defect in T2D and is consistent with improvements observed after more traditional aerobic exercise programmes in overweight/obese adults with T2D.
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Regarding ability to reduce visceral adipose tissue, HbA1c, and fasting glucose, HIIT and SIT seem to have effects at least similar to MICT in both healthy and diabetic subjects.
“Regarding the ability of the different exercise regimens to reduce visceral adipose tissue (VAT), HbA1c, and fasting glucose, HIIT and SIT seem to have effects that are at least similar to those of MICT in both healthy and diabetic subjects (Burgomaster et al., 2008; Fealy et al., 2018; Søgaard et al., 2018; Winding et al., 2018; Sabag et al., 2020).”
From Effect of Exercise Training on Fat Loss—Energetic Perspectives and the Role of Improved Adipose Tissue Function and Body Fat Distribution (2021) · cites this paper as Fealy et al., 2018
The Introduction (page unavailable) says HIIT and SIT may be adequate or superior alternatives to moderate-intensity exercise for metabolic health. The Discussion (page unavailable) reports that fasting glucose tended to decrease after functional high-intensity training in people with type 2 diabetes. The paper does not establish comparable reductions in visceral adipose tissue, HbA1c, and fasting glucose across HIIT, SIT, and MICT in both healthy and diabetic subjects. (LLM, conf=0.87)
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- Authors
- Fealy, C. E., Nieuwoudt, S., Foucher, J. A., Scelsi, A. R., Malin, S. K., Pagadala, M., Cruz, L. A., Li, M., Rocco, M., Burguera, B., & Kirwan, J. P.
- Affiliations
- Cleveland Clinic (US)
- Corresponding author
- Kirwan, John P.
- Venue
- Experimental Physiology
- Publisher
- Wiley
- Published
- 2018-06-28
- Volume
- 103
- Issue
- 7
- Pages
- 985-994
- ISSN
- 0958-0670 (ISSN-L)
- 1469-445X
- PMC
- PMC6026040
- OpenAlex
- W2804415505
- Cited by
- 84
- References
- 64
- Citations by year
- 2026: 5 · 2025: 9 · 2024: 8 · 2023: 18 · 2022: 16 · 2021: 10 · 2020: 6 · 2019: 7 · 2018: 4
- FWCI
- 9.27
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Experimental Physiology (publishedVersion, other-oa)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health, National Center for Research Resources Grant (UL1RR024989)
- Cleveland Clinic Research Support Award (RPC 2013-1010)
- Crossfit inc.
- Topics
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- type 2 diabetes, insulin resistance, insulin sensitivity, cardiometabolic risk, metabolic syndrome, aerobic and resistance exercise, fat oxidation, adiponectin, serum lipids, blood pressure, fat mass, short-duration exercise, exercise training intervention, overweight and obesity, glucose tolerance, lipolysis, lipoprotein lipase, adipose tissue browning
- MeSH terms
- High-Intensity Interval Training, Cardiovascular Diseases, Diabetes Mellitus, Type 2, Female, Glucose Tolerance Test, Humans, Insulin Resistance, Male, Middle Aged, Obesity, Risk Factors, Body Mass Index, Metabolic Syndrome, Overweight
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