Effect of high-intensity interval training protocols on VO2max and HbA1c level in people with type 2 diabetes: A systematic review and meta-analysis

Background: The effect of high-intensity interval training (HIIT) protocols according to different work intervals, session volumes and training periods has not been evaluated in patients with type 2 diabetes mellitus (T2DM). Objective: This was a systematic review and meta-analysis of the effect of HIIT and its different protocols compared to moderate-intensity continuous training (MICT) and the control group on VO(2)max and glycated hemoglobin (HbA1c) level in patients with T2DM. Methods: The search strategy considered studies published up to September 2020 in the databases MEDLINE (PubMed), EMBASE, Cochrane CENTRAL, Web of Science and SPORTDiscus. Two authors independently searched the selected databases for randomized clinical trials that compared HIIT to MICT or the control in adults with T2DM. A random-effects meta-analysis was performed and the data are presented as the mean difference (95% confidence intervals [95% CIs]) between HIIT, MICT and control groups. Results: A total of 20 studies (738 participants) were included. Overall, HIIT increased VO(2)max by 5.09 mL/kg/min (95% CI 2.99; 7.19, I-2 = 80.89) versus the control and by 1.9 mL/kg/min (95% CI 0.81; 2.98, I-2 = 25.62) versus MICT. HIIT promoted a significant reduction in HbAlc level of -0.8% (95% CI -1.06; -0.49, I-2 = 77.31) versus the control but with no difference versus MICT. Moderate-interval, high-volume and long-term training promoted a greater increase in VO(2)max. A long interval and moderate volume and period conferred a greater increase in VO(2)max versus MICT. A short interval and moderate volume and period conferred a greater reduction in HbA1c level versus the control. No publication bias was detected, as evaluated by a funnel chart and Egger's test (p > 0.05). Conclusions: As compared with MICT, HIIT had better effect on VO(2)max and a similar effect on HbA1C level. Interval protocols, moderate to long training period and moderate to high volume may maximize the HIIT effect in patients with T2DM. (C) 2021 Elsevier Masson SAS. All rights reserved.