Short Bursts of High-Intensity Exercise More Beneficial in Type 2 Diabetes

ORLANDO, Fla. — Short bursts of high-intensity exercise appeared to improve cholesterol, blood sugar, and weight in patients with type 2 diabetes, as compared with 30 minutes of sustained, lower-intensity exercise, new data presented at the American Heart Association Scientific Sessions suggest.

The current standard of care for exercise rehabilitation in patients with diabetes is sustained exercise, but recent studies have demonstrated some potential benefits of burst exercise in healthy volunteers, according to study author Avinash Pandey, an undergraduate student at the University of Western Ontario in London, Ontario, Canada.

However, he noted that there has been little investigation into whether or not those benefits are the same for patients with diabetes.

“While the research into burst exercise is an up and coming field, the impacts of burst exercise in diseases such as diabetes have yet to be adequately assessed. The unique part of our study was that we assessed the impacts of burst exercise across a wide variety of cardiometabolic parameters such as HbA1C, lipid profiles, BMI and cardiopulmonary fitness,” said Pandey.

“Additionally, we compared adherence to the burst exercise and sustained exercise regimens — something that has yet to be assessed previously. Our study showed that patients are far more adherent to short burst exercise and that per-minute burst exercise yields greater cardiometabolic benefits compared to sustained exercise.”

More may be accomplished with short bursts of vigorous exercise, in which patients achieve a higher maximum target heart rate, and may be easier to fit into busy schedules, he explained.

The study was conducted in 76 participants with type 2 diabetes (mean age, 67 years; 70% men). All of the volunteers were recruited for the study shortly after their diagnosis of type 2 diabetes.

Participants were randomly assigned to 30 minutes of exercise 5 days a week at 65% of their target heart rate or 10 minutes of exercise 3 times a day 5 days a week at 85% of their target heart rate.

After 3 months, short bursts of exercise were associated with an average decrease in 3-month HbA1c patterns of 0.82%, as compared with 0.25% among those who exercised at a lower intensity for longer periods of time.

“While the impacts of burst exercise and sustained exercise on hard clinical outcomes like diabetic micro- or macrovascular disease were not assessed, this study showed that in a short period of observation patients were able to significantly reduce important cardiometabolic parameters with burst exercise,” Pandey told Endocrinology Advisor. 

“Patients prescribed burst exercise experienced 3.3-fold greater reduction in HbA1c with burst exercise compared to sustained exercise, and a 2.3-fold reduction in LDL cholesterol with burst exercise. Overall, this suggests that burst exercise may represent a superior form of exercise for individuals with diabetes.”

Consequently, burst exercise could result in meaningful clinical improvements in diabetes control and cardiovascular risk, Pandey said, although further research is necessary to confirm these results. Additionally, studies examining the impacts of this burst exercise regimen in larger and more diverse patient populations over extended periods of follow-up are needed.

He added that it is paramount to assess the impact of burst exercise on macrovascular and microvascular complications of diabetes.

The findings overall suggest that some exercise is good, but more exercise is better, according to Pandey. The patients in this current study exercised significantly more in terms of duration, frequency, and intensity when prescribed burst exercise. 

In terms of per-minute exercise, burst exercise appeared to yield greater cardiometabolic benefits, even among patients who exercised for the same duration of time.

“For endocrinologists, I believe this study reinforces the important role that exercise can play in diabetes management and cardiac risk reduction. Even in the sustained exercise group, where individuals appeared to exercise less, we still saw some important improvements in glycemic control, reductions in HbA1C, and improvements in lipid profiles,” said Pandey.

It is important to note, he added, that the researchers specifically excluded all individuals with established or suspected cardiovascular disease as well as long-standing diabetes where silent ischemia could be present since the safety of burst exercise has not been adequately established in such patients.

Reference

1. Pandey A, Poirier P. T 2088 – The Impacts of Burst Exercise Compared to Sustained Exercise on the Cardiometabolic Status and Exercise Behavior of Newly Diagnosed Type 2 Diabetic Patients. Presented at the American Heart Association Scientific Sessions; November 7-11, 2015; Orlando, FL.