Insulin Resistance and Activity

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(1) High Intensity Interval Training – HIIT

Article from PLOS One:   LINK to full text

“High Intensity Interval Training Improves Glycaemic Control and Pancreatic β Cell Function of Type 2 Diabetes Patients”
Søren Møller Madsen, Anne Cathrine Thorup, Kristian Overgaard, Per Bendix Jeppesen,  August 10, 2015DOI: 10.1371/journal.pone.0133286

Note that the subjects in this study went through a careful selection process, they underwent testing to arrive at their individualized training targets and they exercised under direct supervision. From the article:

• It is well established that physical activity per se improves glucose homeostasis [2–4], a cornerstone of regulating overall glycaemic control among T2D patients.
• As of 2013, it is recommended that T2D patients should perform at least 150 minutes per week of moderate-intensity aerobic exercise corresponding to 50–70% of maximal heart frequency [5,6].
• Since Bjorntorp and co-workers established the importance of regular moderate to strenuous exercise to increase insulin sensitivity among T2D patients [7], considerable molecular and metabolic research has demonstrated pivotal (patho)physiological linkages between health-related benefits of physical activity and T2D.
• Recently, more focus has addressed the health beneficial effects of different high intensity interval training (HIIT) regimens to T2D. Novel findings here include reduced hyperglycaemia following 2 weeks of HIIT on cycle ergometer [8,9], ameliorated insulin action and upregulated skeletal muscle metabolic capacity after walking intervals [10] and improved pancreatic β-cell function [11]–pivotal physiological phenomena in the attempt to regulate whole body metabolism in T2D patients.
• These health beneficial effects seem to be independent of changes in body weight in moderate intensity training regimens [12–14], and glycaemic control may be even more improved by intensities above recommended guidelines [15,16].
• There seems to be accumulating evidence that HIIT induces increased overall fat loss and abdominal fat mass loss as opposed to traditional continuous endurance training [17].
• Subjects conducted supervised HIIT on a cycling ergometer (Kettler Axiom, Germany) three times per week over 8 weeks (every Monday, Wednesday and Friday) in three groups of five and two groups of four. During the entire intervention, a physiotherapist supervised the subjects to control that they adhered to and completed their individual power output obtained from their O2max test. Halfway through the intervention subjects had their power output increased by ~5% for the remaining period in order to maintain a sufficient relative intensity despite neural and muscular adaptations. Each training session consisted of a 5-minute warm-up (eliciting ~65% of HRmax) followed by 10×1 minute intervals each interspersed by 1 minute of recovery [9,24]. Cadence during the HIIT was ~70 RPM. During recovery, the participants were allowed to either rest or pedal with a minimum of resistance. The session was completed by a cool-down period of 5 minutes. Total time commitment was ~30 minutes per HIIT session.
• Conclusion: these results demonstrate that HIIT improves overall glycaemic control and pancreatic β cell function in T2D patients. Additionally, both groups experienced abdominal fat mass losses. These findings demonstrate that HIIT is a health beneficial exercise strategy in T2D patients.