Time Efficient Exercise in Type 2 Diabetes
Condition: Diabetes Mellitus, Type 2
MeSH terms: Diabetes Mellitus; Diabetes Mellitus, Type 2
Study type: Interventional

Summary: 
      Exercise is considered a cornerstone in the prevention and treatment of type 2 diabetes, but
      few patients exercise according to guidelines. In this study the effect of two time efficient
      high intensity exercise protocols on glycemic control and other cardiometabolic risk factors
      are investigated in patients with type 2 diabetes.The investigators assume that glycemic
      control is improved more by low-volume high intensity interval training than by extremely
      low-volume sprint interval training.
    

Detailed description: 
      The world prevalence of diabetes mellitus for 2010 is estimated to 6.4 % of the adult
      population, and an increase up to 7.7 % is expected before 2030. 90-95 % individuals with
      diabetes have type 2 diabetes (T2D).

      The complications of T2D lead to substantially increased risk of hypertension, cardiovascular
      disease (CVD) and the development of heart failure. CVD is the most common cause of death in
      European adults with diabetes, and the risk of developing CVD is double of that observed in
      individuals without diabetes. Lowering HbA1c in type 2 diabetes decreases the absolute risk
      of developing CVD by 5-17 %, as well as decreasing all-cause mortality by 6-15 %.

      Individuals with T2D are recommended to exercise moderately or vigorously for at least 150
      minutes per week. However, the majority of adults fail to meet the guidelines for even the
      minimum amount of physical activity, and lack of time is often cited as the main reason.

      This research group has previously shown that 4x4 minute high intensity aerobic interval
      training (AIT) yields significantly greater response on HbA1c, BMI and diastolic dysfunction
      in patients with T2D with duration <10years in contrast to present recommendations. AIT
      reduces cardiovascular risk factors more than moderate continuous training in patients with
      heart failure and metabolic syndrome. In metabolic syndrome, AIT is superior in enhancing
      endothelial function, insulin signaling in fat and skeletal muscle and in reducing blood
      glucose. This shows that AIT is a time-efficient and highly effective form of exercise for
      both patients with T2D and other patient groups.

      Recently, even lower training volumes than made use of in the projects presented above, have
      shown indications of improving glycaemic control in T2D. Only two weeks with a total of six
      sessions of high intensity training reduces blood glucose significantly in individuals with
      T2D. Even shorter intervals of all-out activity (2-7 bouts of 20-30 seconds of supramaximal
      ergometer cycling) was shown to improve both aerobic capacity and a number of metabolic and
      cardiovascular risk factors after few weeks of training.

      However, low-volume high-intensity exercise studies are limited for T2D. The present study
      aims to compare the effect of two time saving, high intensity exercise protocols on
      cardiovascular risk factors in patients with type 2 diabetes. The investigators assume that
      glycemic control is improved more by low-volume high intensity interval training than by
      extremely low-volume sprint interval training.
    

Intervention name(s): High intensity interval training; Sprint interval training
Intervention type(s): Behavioral; Behavioral
Intervention description(s): High intensity exercise during 12 weeks with three weekly training sessions; Sprint interval exercise during 12 weeks with three weekly training sessions
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Exercise; Risk factors; Exercise therapy; Hemoglobin A, Glycosylated