Functional high-intensity exercise training ameliorates insulin resistance and cardiometabolic risk factors in type 2 diabetes

Functional high-intensity training (F-HIT) is a novel fitness paradigm that integrates simultaneous aerobic and resistance training in sets of constantly varied movements, based on real-world situational exercises, performed at high-intensity in workouts that range from approximate to 8 to 20min per session. We hypothesized that F-HIT would be an effective exercise mode for reducing insulin resistance in type 2 diabetes (T2D). We recruited 13 overweight/obese adults (5 males, 8 females; 53 +/- 7years; BMI 34.5 +/- 3.6kgm(-2), means +/- SD) with T2D to participate in a 6-week (3daysweek(-1)) supervised F-HIT programme. An oral glucose tolerance test was used to derive measures of insulin sensitivity. F-HIT significantly reduced fat mass (43.8 +/- 83.8vs. 41.6 +/- 7.9kg; P<0.01), diastolic blood pressure (80.2 +/- 7.1vs. 74.5 +/- 5.8; P<0.01), blood lipids (triglyceride and VLDL, both P<0.05) and metabolic syndrome z-score (6.4 +/- 4.5vs. -0.2 +/- 5.2AU; P<0.001), and increased basal fat oxidation (0.08 +/- 0.03vs. 0.10 +/- 0.04gmin(-1); P=0.05), and high molecular mass adiponectin (214.4 +/- 88.9vs. 288.8 +/- 127.4ngmL(-1); P<0.01). Importantly, F-HIT also increased insulin sensitivity (0.037 +/- 0.010vs. 0.042 +/- 0.010 AU; P<0.05). Increases in high molecular mass adiponectin and basal fat oxidation correlated with the change in insulin sensitivity (, 0.75, P<0.05 and , 0.81, P<0.01, respectively). Compliance with the training programme was >95% and no injuries or adverse events were reported. These data suggest that F-HIT may be an effective exercise mode for managing T2D. The increase in insulin sensitivity addresses a key defect in T2D and is consistent with improvements observed after more traditional aerobic exercise programmes in overweight/obese adults with T2D.