Abstract

Simple SummaryDiabetes mellitus is a metabolic disorder characterized by an increased blood glucose concentration. The most common diabetes is type 2, corresponding to approximately 95% of the diagnosed cases. Chronic hyperglycemia can lead to many complications such as increased incidence of cardiovascular diseases as well as renal and ophthalmologic complications. Physical exercise is seen as an effective non-pharmacological strategy for managing the disease. In the present study, 44 middle-aged adults with type 2 diabetes were recruited and stratified into three exercise groups: HIIT-30:30, HIIT-2:2, and MICT. All patients were submitted to anamnesis, evaluation of cardiorespiratory fitness, and cardiac autonomic modulation, and were submitted to physical exercise programs for eight weeks. From the results found, it was possible to infer that high intensity physical training programs can be safe and effective for patients with type 2 diabetes and might be performed in different phases of a rehabilitation program. However, it is necessary to know how to work with the prescription of these exercises considering its cost effectiveness, because, in this study, the protocols HIIT-2:2 and HIIT-30:30 presented superior benefits to the MICT protocol.Different exercise models have been used in patients with type 2 diabetes mellitus (T2D), like moderate intensity continuous training (MICT) and high intensity interval training (HIIT); however, their effects on autonomic modulation are unknown. The present study aimed to compare the effects of different exercise modes on autonomic modulation in patients with T2D. In total, 44 adults with >5 years of T2D diagnosis were recruited and stratified into three groups: HIIT-30:30 (n = 15, age 59.13 ± 5.57 years) that performed 20 repetitions of 30 s at 100% of VO2peak with passive recovery, HIIT-2:2 (n = 14, age 61.20 ± 2.88) that performed 5 repetitions of 2 min at 100% of VO2peak with passive recovery, and MICT (n = 15, age 58.50 ± 5.26) that performed 14 min of continuous exercise at 70% of VO2peak. All participants underwent anamnesis and evaluation of cardiorespiratory fitness and cardiac autonomic modulation. All protocols were equated by total distance and were performed two times per week for 8 weeks. Group × time interactions were observed for resting heart rate (HRrest) [F(2.82) = 3.641; p = 0.031] and SDNN [F(2.82) = 3.462; p = 0.036]. Only the HIIT-30:30 group significantly reduced SDNN (p = 0.002 and 0.025, respectively). HRrest reduced more in the HIIT-30:30 group compared with the MICT group (p = 0.038). Group × time interactions were also observed for offTAU [F(2.82) = 3.146; p = 0.048] and offTMR [F(2.82) = 4.424; p = 0.015]. The MICT group presented increased values of offTAU compared with the HIIT-30:30 and HIIT-2:2 groups (p = 0.001 and 0.013, respectively), representing a slower HR response after eight weeks of intervention. HIIT, specially HIIT-30:30, represents a promising measure for improving autonomic modulation in patients with T2D.

Highlights

  • Projections estimate that, by 2045, the number of people diagnosed with diabetes will reach 693 million worldwide [1]

  • The two-way ANOVA revealed the effect of the intervention in the variables HRpeak [F(2.82) = 5.091; p = 0.009] and pNN50 [F(2.82) = 5.071; p = 0.008], with a significant increase observed only in the high intensity interval training (HIIT)-30:30 group

  • Time effect was observed in the variables HRrest [F(1.82) = 7,097; p = 0.009], with a reduction observed for HIIT-30:30 group, R-Ri [F(1.82) = 0.045; p = 0.001], pNN50 [F (1.81) = 10.413; p = 0.002], and 2UV% [F(1.82) = 9.285; p = 0.003], with the HIIT-30:30 group presenting a postintervention increase

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Summary

Introduction

Projections estimate that, by 2045, the number of people diagnosed with diabetes will reach 693 million worldwide [1]. Type 2 diabetes (T2D) represents 90–95% of diagnoses, is more prevalent in adults over 40 years old, and can be caused by environmental (association with risk factors, such as obesity and sedentary lifestyle) or genetic factors [2]. Among the many problems in the cardiovascular system associated with T2D [4], there seems to be an association between chronic hyperglycemia and changes in cardiovascular autonomic nervous system, as verified by heart rate variability (HRV) indexes [5,6]. The association between cardiac autonomic modulation and cardiovascular events, as well as all-cause mortality, in the general population has been described in the current literature; individuals with low values for HRV and HRR present a higher risk of some severe cardiovascular outcome, which seems to associated with a deficiency in response to physiological stress [3,8]. It seems important to evaluate these variables in populations with different clinical conditions and under stress

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