High Intensity Circuit Training vs Traditional Exercise for Type 2 Diabetes

Overseen By Brian Kliszczewicz, Ph.D.

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Kennesaw State University

Disqualifiers: Revascularization, Renal, Pulmonary, CVD, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 16 weeks

42 Participants Needed

Trial Summary

What is the purpose of this trial?

This research study proposes to quantify the efficacy of the novel high intensity body-weight circuit (HIBC) training intervention on metabolic profile, body composition, and health related fitness exercise in middle aged persons with type-2 diabetes (T2DM). This research project is extremely relevant to public health, in that prevalence of T2DM continues to rise on a national and global scale, placing a heavy economic cost on both the healthcare industry and the individual patient in an age-dependent fashion. Results of this study may provide an effective and appealing alternative exercise intervention for cardiometabolic disease management in adults with T2DM, and have significant clinical and public health applications.

Will I have to stop taking my current medications?

The trial requires that participants are not on any medicinal treatment for their diabetes, so you would need to stop taking any diabetes medications before joining.

What data supports the effectiveness of the treatment High Intensity Circuit Training for Type 2 Diabetes?

Research shows that high-intensity exercise, including circuit training, can improve blood sugar control and reduce insulin levels in people with type 2 diabetes. This type of exercise is also time-efficient and can improve heart health and muscle function, making it a beneficial option for managing diabetes. ^{1 2 3 4 5}

Is high-intensity circuit training safe for humans?

High-intensity circuit training (HICT) has been studied in various groups, including obese women and middle-aged men, and is generally considered safe when performed appropriately. It can improve physical fitness and cardiovascular health, but as with any exercise program, it's important to start at a suitable level and increase intensity gradually to avoid injury. ^{3 4 6 7 8}

How does high-intensity circuit training differ from traditional exercise for type 2 diabetes?

High-intensity circuit training is unique because it combines short bursts of intense exercise with rest periods, making it a time-efficient alternative to traditional exercise. This approach can improve blood sugar control and physical fitness in people with type 2 diabetes, even with a lower overall time commitment compared to moderate-intensity exercise. ^{3 4 9 10 11}

Eligibility Criteria

This trial is for middle-aged individuals recently diagnosed with type-2 diabetes who haven't started any medicinal treatment and are not insulin-dependent. They should have an HbA1c level between 6% and 8%, no current exercise program, and must be willing to be randomly assigned to a workout group. Smokers or those with kidney, lung, heart diseases, past revascularization procedures, or cognitive dysfunction cannot participate.

Inclusion Criteria

I was diagnosed with type 2 diabetes within the last year.

I do not need insulin for my diabetes.

Your HbA1c level is between 6% and 8%.

Exclusion Criteria

You are currently smoking cigarettes.

I have had a procedure to improve blood flow to my heart.

You have been diagnosed with problems related to thinking and memory.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants undergo high intensity body-weight circuit (HIBC) training, starting with three sessions per week, increasing to four sessions per week after three weeks. Session duration starts at 5 minutes and increases by one minute each week, peaking at 10 minutes by the eighth week.

16 weeks

Sessions completed at home

Follow-up

Participants are monitored for changes in body composition, VO2max, glucose tolerance, and HbA1c levels after the intervention.

4 weeks

Treatment Details

Interventions

• high intensity body-weight circuit
• traditional exercise intervention (TEI)

Trial Overview The study is testing the effectiveness of a new high intensity body-weight circuit (HIBC) training compared to traditional exercise interventions (TEI). It aims to see which one better improves metabolic profile, body composition, and fitness in people with type-2 diabetes.

Participant Groups

Group I: high intensity body-weight circuit (HIBC) Experimental Treatment 1 Intervention

HIBC Exercise Protocol- circuit repetition and order is as follows: modified squats (10 repetitions), modified rows (5 repetitions), crunches (10), and modified push-ups (5). The exercise sessions will involve repeating a series of repetitions of each movement in sequence, and completing as many sequences as possible in good form in the time allotted for the exercise (initially, 5 minutes). Three sessions per week will be completed at home. After three weeks of training, participants will be asked to add a fourth session each week. Initially, the HIBC sessions will be five minutes long, and the duration of the sessions will increase by one minute each week as tolerated beginning in week four, peaking at 10-minutes per session (warm up not included in this timing) as early as the eighth week of training. Session duration will be capped at 10-minutes.

Who Is Running the Clinical Trial?

Kennesaw State University

Lead Sponsor

Trials

14

Recruited

860+

Findings from Research

A 3-month circuit resistance training program significantly improved long-term glycaemic control in subjects with non-insulin-dependent diabetes mellitus (NIDDM), as indicated by a reduction in HbA1c from 8.8% to 8.2%.

The study found a strong inverse correlation between muscle size (measured by thigh muscle cross-sectional area) and HbA1c levels, suggesting that increased muscle mass may enhance glycaemic control in NIDDM patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Resistance training in the treatment of non-insulin-dependent diabetes mellitus. Eriksson, J., Taimela, S., Eriksson, K., et al.[2022]

A meta-analysis of 24 trials involving 962 patients with type 2 diabetes showed that high-intensity resistance exercise significantly reduced HbA1c levels and insulin levels compared to low-to-moderate intensity exercise.

Specifically, high-intensity resistance exercise led to a greater decrease in HbA1c (-0.61) and insulin levels (-4.60), highlighting its effectiveness in improving glycemic control in patients with type 2 diabetes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Resistance Exercise Intensity is Correlated with Attenuation of HbA1c and Insulin in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis. Liu, Y., Ye, W., Chen, Q., et al.[2022]

A 12-week study involving 15 participants with type 2 diabetes showed that high intensity interval exercise (HI-IE) is as feasible as moderate intensity continuous exercise (MI-CE), with both groups maintaining high adherence rates of over 97%.

Both HI-IE and MI-CE effectively reduced total body fat and trunk fat, but neither intervention significantly changed glycated hemoglobin A1c (HbA1c) levels, indicating limited impact on blood sugar control in participants who were already well-managed.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Feasibility and preliminary efficacy of high intensity interval training in type 2 diabetes. Terada, T., Friesen, A., Chahal, BS., et al.[2022]

High-intensity (HI) exercise training is a time-efficient alternative to traditional moderate-intensity (MI) exercise for prediabetic adults, allowing them to meet physical activity guidelines with less overall time commitment.

HI exercise training has been shown to improve skeletal muscle metabolic control and cardiovascular function comparably or even superiorly to low-intensity (LI) and MI exercise, making it an effective option for reducing cardiometabolic risk in prediabetic patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

High-intensity exercise training for the prevention of type 2 diabetes mellitus. Rynders, CA., Weltman, A.[2014]

Low-volume walking high-intensity interval training (HIIT) significantly improved physical capacity, including greater increases in distance covered during a 6-minute walk test and grip strength compared to moderate-intensity continuous training (MICT) in older women with type 2 diabetes.

Both HIIT and MICT reduced resting blood pressure and improved cardiovascular risk scores, but neither training method significantly affected ambulatory blood pressure or lipid profiles after 12 weeks.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Low-volume walking HIIT: Efficient strategy to improve physical capacity and reduce the risk of cardiovascular disease in older women with type 2 diabetes. Marcotte-Chénard, A., Tremblay, D., Mony, MM., et al.[2022]

An 8-week modified high-intensity circuit training program significantly improved various health-related fitness measures in 24 sedentary obese women, including flexibility, muscle strength, and cardiovascular endurance.

Participants in the training group experienced notable changes in body composition, such as increased skeletal muscle mass and decreased body fat percentage, compared to a control group, highlighting the efficacy of this training modality.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Body composition and physical fitness improve after 8 weeks of high-intensity circuit training using body weight in obese women. Ajjimaporn, A., Khemtong, C., Willems, ME.[2023]

High-intensity circuit training (HICT) significantly reduced fat mass, diastolic blood pressure, total cholesterol, LDL cholesterol, triglycerides, and ApoB levels while increasing HDL cholesterol in healthy, overweight middle-aged individuals over 12 weeks.

Compared to traditional endurance training and low-intensity circuit training, HICT was more effective in improving cardiovascular disease risk factors, highlighting its potential as a superior exercise intervention for this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of high-intensity circuit training, low-intensity circuit training and endurance training on blood pressure and lipoproteins in middle-aged overweight men. Paoli, A., Pacelli, QF., Moro, T., et al.[2022]

Integrating high-intensity interval training (HIIT) before circuit weight training (CWT) leads to greater energy expenditure and metabolic response compared to a circuit training-first approach, indicating a more intense workout effect.

Both exercise protocols (HIIT followed by CWT and a combined circuit with HIIT) resulted in similar heart rate and perceived exertion levels, suggesting that while HIIT before CWT is more metabolically demanding, both methods are effective for overall caloric burn.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Metabolic effects of two high-intensity circuit training protocols: Does sequence matter? Nuñez, TP., Amorim, FT., Beltz, NM., et al.[2022]

High-Intensity Interval Training (HIIT) significantly improves glycaemic control, aerobic resistance, and body composition in individuals with type 2 diabetes, based on a meta-analysis of 180 studies involving participants aged 18 and older.

Specific types of HIIT, such as Sprint Interval HIIT (SIT-HIIT) and Short Interval HIIT (SI-HIIT), may offer greater benefits for fasting blood glucose levels compared to traditional continuous aerobic training.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effect of chronic high-intensity interval training programs on glycaemic control, aerobic resistance, and body composition in type 2 diabetic patients: a meta-analysis. Arrieta-Leandro, MC., Moncada-Jiménez, J., Morales-Scholz, MG., et al.[2023]

A 5-month circuit-type resistance training program significantly improved cholesterol levels and long-term glycemic control (HbA1c) in 38 type 2 diabetic subjects, indicating its effectiveness as a treatment option.

Participants in the resistance training group experienced a notable reduction in total cholesterol, LDL-cholesterol, and triglycerides, suggesting that resistance training can positively impact cardiovascular health in individuals with type 2 diabetes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Resistance training improves the metabolic profile in individuals with type 2 diabetes. Honkola, A., Forsén, T., Eriksson, J.[2022]

Circuit exercise training for 12 weeks significantly improved physical functions such as muscular strength, flexibility, balance, agility, and endurance in elderly patients with type 2 diabetes, along with a reduction in HbA1c levels, indicating better glucose metabolism.

After an 8-week period of detraining, while some improvements in flexibility and agility declined, these parameters remained significantly better than baseline and compared to the control group, suggesting that the benefits of exercise can be partially retained even after stopping training.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects on training and detraining on physical function, control of diabetes and anthropometrics in type 2 diabetes; a randomized controlled trial. Park, SY., Lee, IH.[2014]

References

1. Germany pubmed.ncbi.nlm.nih.gov

Resistance training in the treatment of non-insulin-dependent diabetes mellitus. [2022]

2. Switzerland pubmed.ncbi.nlm.nih.gov

Resistance Exercise Intensity is Correlated with Attenuation of HbA1c and Insulin in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis. [2022]

3. Ireland pubmed.ncbi.nlm.nih.gov

Feasibility and preliminary efficacy of high intensity interval training in type 2 diabetes. [2022]

4. England pubmed.ncbi.nlm.nih.gov

High-intensity exercise training for the prevention of type 2 diabetes mellitus. [2014]

5. Netherlands pubmed.ncbi.nlm.nih.gov

Low-volume walking HIIT: Efficient strategy to improve physical capacity and reduce the risk of cardiovascular disease in older women with type 2 diabetes. [2022]

6. Italy pubmed.ncbi.nlm.nih.gov

Body composition and physical fitness improve after 8 weeks of high-intensity circuit training using body weight in obese women. [2023]

7. England pubmed.ncbi.nlm.nih.gov

Effects of high-intensity circuit training, low-intensity circuit training and endurance training on blood pressure and lipoproteins in middle-aged overweight men. [2022]

8. Singapore pubmed.ncbi.nlm.nih.gov

Metabolic effects of two high-intensity circuit training protocols: Does sequence matter? [2022]

9. Italy pubmed.ncbi.nlm.nih.gov

The effect of chronic high-intensity interval training programs on glycaemic control, aerobic resistance, and body composition in type 2 diabetic patients: a meta-analysis. [2023]

10. Germany pubmed.ncbi.nlm.nih.gov

Resistance training improves the metabolic profile in individuals with type 2 diabetes. [2022]

11. England pubmed.ncbi.nlm.nih.gov

Effects on training and detraining on physical function, control of diabetes and anthropometrics in type 2 diabetes; a randomized controlled trial. [2014]