Aerobic interval training and cardiometabolic health in patients with type 2 diabetes: A meta-analysis

Abstract

Vigorous to maximal aerobic interval training (INT) has received remarkable interest in improving cardiometabolic outcomes for type 2 diabetes patients recently, yet with inconsistent findings. This meta-analysis was aimed to quantify its effectiveness in type 2 diabetes. Randomized controlled trials (RCTs) were identified by searches of 3 databases to October 2017, which evaluated the effects of INT with a minimal training duration of 8 weeks vs. moderate-intensity continuous training (MICT) or non-exercise training (NET) among type 2 diabetes patients on outcomes including cardiorespiratory fitness, glycemic control, body composition, blood pressure, and lipid profiles. Weighted mean differences with 95% confidence intervals (CIs) were calculated with the random-effects model. Nine datasets from 7 RCTs with 189 patients were included. Compared with MICT, INT improved maximal oxygen consumption (VO2max) by 2.60 ml/kg/min (95% CI: 1.32 to 3.88 ml/kg/min, P < 0.001) and decreased hemoglobin A1c (HbA1c) by 0.26% (95% CI: -0.46% to -0.07%, P = 0.008). These outcomes for INT were also significant vs. energy expenditure-matched MICT, with VO2max increased by 2.18 ml/kg/min (P = 0.04) and HbA1c decreased by 0.28% (P = 0.01). Yet their magnitudes of changes were larger compared with NET, with VO2max increased by 6.38 ml/kg/min (P < 0.001) and HbA1c reduced by 0.83% (P = 0.004). Systolic blood pressure could be lowered by INT compared with energy expenditure-matched MICT or NET (both P < 0.05), but other cardiometabolic markers and body composition were not significantly altered in general. In conclusion, despite a limited number of studies, INT improves cardiometabolic health especially for VO2max and HbA1c among patients with type 2 diabetes, and might be considered an alternative to MICT. Yet the optimal training protocols still require to be established.