Background

Individuals with type 1 diabetes mellitus (T1DM) face impaired cardiorespiratory fitness and glycemic control, increasing the risk of cardiovascular complications. High-intensity interval training (HIIT) has emerged as a promising exercise modality with potential benefits for both aspects in this population.

Objectives

The primary aim was to investigate the effects of HIIT on cardiorespiratory fitness and glycemic parameters in patients with T1DM. The secondary aim was to examine the most effective HIIT protocol for cardiorespiratory fitness and glycemic parameters in patients with T1DM.

Design

Systematic review and meta-analysis.

Data Sources

Two major electronic databases (Web of Science and PubMed) were searched up to February 2024.

Eligibility Criteria for Selecting Studies

Randomized and non-randomized trials involving adult patients with T1DM, free of complications and other diseases examining the effects of HIIT (HIIT pre vs. post; HIIT vs. control group or HIIT vs. moderate-intensity continuous training (MICT)) on cardiorespiratory fitness and glycemic parameters were included.

Results

A total of ten studies met the inclusion criteria. The meta-analysis revealed a significant improvement in cardiorespiratory fitness following HIIT interventions (pre vs. post) in patients with T1DM (standardized mean difference (SMD) = 0.59, 95% confidence interval (CI) = 0.16 to 1, p = 0.01). Furthermore, HIIT (pre vs. post) was associated with significant improvements in 24-h mean glucose control (SMD = − 0.44, 95% CI = − 0.81 to − 0.06, p = 0.02), but the results (pre vs. post) failed to identify significant improvements in fasting glucose (SMD = − 0.26, 95% CI = − 0.78 to 0.24, p = 0.3) and glycated hemoglobin (HbA1C) values (SMD = − 0.28, 95% CI = − 0.61 to 0.05, p = 0.1). However, in comparison with a control group, HIIT showed significantly favorable effects on HbA1C (SMD = − 0.74, 95% CI = − 1.35 to − 0.14, p = 0.02). Finally, the meta-regression analysis did not find any moderating effect of any HIIT characteristics (i.e., intervention duration, session duration, work time, rest time, number of bouts, and intensity) on cardiorespiratory fitness and glycemic parameters.

Conclusion

Our systematic review and meta-analysis show that T1DM patients who performed a HIIT intervention significantly improved cardiorespiratory fitness and reduced their 24-h mean glucose levels, but not their HbA1C and fasting glucose. These findings support the application of HIIT interventions in T1DM patients. However, the guidelines for the most effective protocol remain unclear; hence, future studies are needed.

中文翻译：

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HIIT 干预措施对 1 型糖尿病成人心肺健康和血糖参数的影响：系统评价和荟萃分析

 背景

1 型糖尿病 (T1DM) 患者心肺健康和血糖控制受损，增加心血管并发症的风险。高强度间歇训练 (HIIT) 已成为一种很有前途的运动方式，对该人群的两个方面都有潜在的好处。

 目标

主要目的是研究 HIIT 对 T1DM 患者心肺健康和血糖参数的影响。第二个目的是检查对 T1DM 患者的心肺健康和血糖参数最有效的 HIIT 方案。

 设计

系统回顾和荟萃分析。

 数据源

截至 2024 年 2 月，检索了两个主要电子数据库（Web of Science 和 PubMed）。

选择研究的资格标准

随机和非随机试验，涉及无并发症和其他疾病的成年 T1DM 患者，检查 HIIT（HIIT 前与后；HIIT 与对照组或 HIIT 与中等强度持续训练 (MICT)）对心肺功能的影响包括健身和血糖参数。

 结果

共有十项研究符合纳入标准。荟萃分析显示，1 型糖尿病患者接受 HIIT 干预后（治疗前与治疗后），心肺健康显着改善（标准化平均差 (SMD) = 0.59，95% 置信区间 (CI) = 0.16 至 1，p = 0.01） 。此外，HIIT（训练前与训练后）与 24 小时平均血糖控制的显着改善相关（SMD = − 0.44，95% CI = − 0.81 至 − 0.06，p = 0.02），但结果（训练前与训练后） ）未能发现空腹血糖（SMD = − 0.26，95% CI = − 0.78 至 0.24，p = 0.3）和糖化血红蛋白（HbA1C）值（SMD = − 0.28，95% CI = − 0.61 至 0.05）的显着改善， p = 0.1）。然而，与对照组相比，HIIT 对 HbA1C 显示出显着的有利影响（SMD = − 0.74，95% CI = − 1.35 至 − 0.14，p = 0.02）。最后，荟萃回归分析没有发现任何 HIIT 特征（即干预持续时间、训练持续时间、工作时间、休息时间、发作次数和强度）对心肺健康和血糖参数有任何调节作用。

 结论

我们的系统回顾和荟萃分析表明，进行 HIIT 干预的 T1DM 患者显着改善了心肺健康并降低了 24 小时平均血糖水平，但没有降低 HbA1C 和空腹血糖。这些发现支持 HIIT 干预措施在 T1DM 患者中的应用。然而，最有效的方案指南仍不清楚；因此，需要进一步的研究。