Targeting specific interstitial glycemic parameters with high-intensity interval exercise and fasted-state exercise in type 2 diabetes

Metabolism. 2016 May;65(5):599-608. doi: 10.1016/j.metabol.2016.01.003. Epub 2016 Jan 11.


Aims: To compare the acute glycemic responses to a bout of high-intensity interval exercise (HIIE) and energy-matched moderate-intensity continuous exercise (MICE) performed under fasted and postprandial conditions.

Methods: A randomized, controlled, crossover design was used. Ten individuals with type 2 diabetes were each tested in five experimental conditions after an overnight fast: 1) fasted-state HIIE (HIIEfast); 2) post-breakfast HIIE (HIIEfed); 3) fasted-state MICE (MICEfast); 4) post-breakfast MICE (MICEfed); and 5) no exercise (control). MICE was performed at workload corresponding to 55% of V.V̇O2peak, whereas HIIE was composed of repetitions of three minutes at workload corresponding to 40% followed by one minute at workload corresponding to 100% V.V̇̇O2peak. Interstitial glucose was monitored by continuous glucose monitoring over 24h under standardized diet and medication.

Results: Fasted-state exercise attenuated postprandial glycemic increments (p<0.05) to a greater extent than post-breakfast exercise did. HIIE reduced nocturnal and fasting glycemia on the day following exercise more than MICE did (main effect: both p<0.05). Compared to the control condition, HIIEfast lowered most interstitial glycemic parameters, i.e., 24-h mean glucose (-1.5mmol·l(-1); p<0.05), fasting glucose (-1.0mmol·l(-1); p<0.05), overall postprandial glycemic increment (-257mmol·360min·l(-1); p<0.05), glycemic variability (-1.79mmol·l(-1); p<0.05), and time spent in hyperglycemia (-283min; p<0.05).

Conclusion: This study showed that HIIE is more effective than MICE in lowering nocturnal/fasting glycemia. Exercise performed in the fasted state reduces postprandial glycemic increments to a greater extent than post-breakfast exercise does. Performing HIIE under fasted condition may be most advantageous as it lowered most aspects of glycemia.

Keywords: Continuous glucose monitoring; Fasted-state exercise; Glycemic variability; High-intensity interval exercise; Postprandial glucose concentration.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Alberta
  • Breakfast
  • Cross-Over Studies
  • Diabetes Mellitus, Type 2 / metabolism
  • Diabetes Mellitus, Type 2 / therapy*
  • Energy Metabolism
  • Extracellular Fluid / metabolism
  • Fasting
  • Female
  • Glucose / metabolism
  • Humans
  • Hyperglycemia / etiology
  • Hyperglycemia / prevention & control*
  • Hypoglycemia / etiology
  • Hypoglycemia / prevention & control*
  • Male
  • Middle Aged
  • Monitoring, Ambulatory
  • Motor Activity*
  • Oxygen Consumption
  • Physical Exertion*
  • Postprandial Period


  • Glucose