Document Type

Article

Publication Date

2025

DOI

10.1186/s13098-025-01909-z

Publication Title

Diabetology & Metabolic Syndrome

Volume

17

Issue

1

Pages

331 (1-20)

Abstract

Objective

To evaluate the effects of high-intensity interval training (HIIT) on cardiometabolic health-related outcomes in patients with type 2 diabetes mellitus and concurrent overweight/obesity (diabesity).

Design

Systematic review and meta-analysis of randomized controlled trials (RCTs).

Data sources

PubMed, Web of Science, Scopus, Science Direct, Cochrane Library, and Google Scholar databases were searched from inception up to January 31, 2025.

Eligibility criteria for selected studies

RCTs comparing HIIT alone ≥ 2 weeks in duration with moderate-intensity continuous training (MICT). Participants were adults with diabesity.

Results

A total of 26 RCTs qualified, involving 790 patients (50/50 female/male ratio; age: 59.8 ± 12.9 years; body mass index: 28.9 ± 4.2 kg/m(2)). HIIT revealed a significant reduction in fasting insulin [standardized mean differences (SMD) - 0.43, 95% CI - 0.82 to - 0.05] and homeostatic model assessment for insulin resistance (HOMA-IR; SMD - 0.52, 95% CI - 0.97 to - 0.07) compared to MICT. Additionally, HIIT significantly increased cardiorespiratory fitness (VO₂max; SMD 0.53, 95% CI 0.14 to 0.91) compared to MICT. Other clinically relevant cardiometabolic outcomes, including body composition, lipid profile, fasting blood glucose, glycated hemoglobin, and blood pressure, showed comparable changes between HIIT and MICT. Subgroup analyses of studies reporting comorbidities indicated a significant increase in high-density lipoprotein cholesterol (SMD 0.49, 95% CI 0.04 to 0.95) and a decrease in HOMA-IR (SMD - 0.83, 95% CI - 1.62 to - 0.04) for HIIT compared to MICT. However, these findings are limited by very low certainty evidence and non-robust sensitivity analyses.

Conclusions

The present findings suggest that HIIT may serve as an adjunctive non-pharmaceutical management solution for patients with diabesity. Open Science Framework registry: https://osf.io/9by24.

Rights

© The Authors 2025.

This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original authors and the source, provide a link to the Creative Commons license, and indicate if you modified the licensed material. You do not have permission under this license to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.

Data Availability

Article states: "No datasets were generated or analysed during the current study."

Original Publication Citation

Al-Mhanna, S. B., Poon, E. T., Franklin, B. A., Tarnopolsky, M. A., Hawley, J. A., Jakicic, J. M., Stamatakis, E., Little, J. P., Pescatello, L. S., Riebe, D., Thompson, W. R., Skinner, J. S., Colberg, S. R., Ehrman, J. K., Metsios, G. S., Douda, H. T., Omar, N., Alghannam, A. F., & Batrakoulis, A. (2025). Comparative effectiveness of high-intensity interval training and moderate-intensity continuous training on cardiometabolic health in patients with diabesity: A systematic review and meta-analysis of randomized controlled trials. Diabetology & Metabolic Syndrome, 17(1), 1-20, Article 331. https://doi.org/10.1186/s13098-025-01909-z

ORCID

0000-0001-7574-2533 (Colberg)

Additional Files
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