High intensity interval training protects the heart during increased metabolic demand in patients with type 2 diabetes: a randomised controlled trial

Jose Suryanegara, Sophie Cassidy, Vladan Ninkovic, Dejana Popovic, Miljan Grbovic, Nduka Okwose, Michael I Trenell, Guy G MacGowan, Djordje G Jakovljevic

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AIM: The present study assessed the effect of high intensity interval training on cardiac function during prolonged submaximal exercise in patients with type 2 diabetes.

METHODS: Twenty-six patients with type 2 diabetes were randomized to a 12 week of high intensity interval training (3 sessions/week) or standard care control group. All patients underwent prolonged (i.e. 60 min) submaximal cardiopulmonary exercise testing (at 50% of previously assess maximal functional capacity) with non-invasive gas-exchange and haemodynamic measurements including cardiac output and stroke volume before and after the intervention.

RESULTS: At baseline (prior to intervention) there was no significant difference between the intervention and control group in peak exercise oxygen consumption (20.3 ± 6.1 vs. 21.7 ± 5.5 ml/kg/min, p = 0.21), and peak exercise heart rate (156.3 ± 15.0 vs. 153.8 ± 12.5 beats/min, p = 0.28). During follow-up assessment both groups utilized similar amount of oxygen during prolonged submaximal exercise (15.0 ± 2.4 vs. 15.2 ± 2.2 ml/min/kg, p = 0.71). However, cardiac function i.e. cardiac output during submaximal exercise decreased significantly by 21% in exercise group (16.2 ± 2.7-12.8 ± 3.6 L/min, p = 0.03), but not in the control group (15.7 ± 4.9-16.3 ± 4.1 L/min, p = 0.12). Reduction in exercise cardiac output observed in the exercise group was due to a significant decrease in stroke volume by 13% (p = 0.03) and heart rate by 9% (p = 0.04).

CONCLUSION: Following high intensity interval training patients with type 2 diabetes demonstrate reduced cardiac output during prolonged submaximal cardiopulmonary exercise testing. Ability of patients to maintain prolonged increased metabolic demand but with reduced cardiac output suggests cardiac protective role of high intensity interval training in type 2 diabetes.

TRIAL REGISTRATION: ISRCTN78698481. Registered 23 January 2013, retrospectively registered.

Original languageEnglish
Pages (from-to)321-329
Number of pages9
JournalActa Diabetologica
Early online date1 Nov 2018
Publication statusPublished - 6 Mar 2019
Externally publishedYes

Bibliographical note

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.


  • Aged
  • Combined Modality Therapy
  • Diabetes Mellitus, Type 2/complications
  • Diabetic Angiopathies/metabolism
  • Diet
  • Exercise Therapy/methods
  • Female
  • High-Intensity Interval Training
  • Humans
  • Male
  • Metformin/therapeutic use
  • Middle Aged
  • Myocardium/metabolism
  • Oxygen Consumption/physiology


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