HIIT and RT for Diabetes NMAND.pdf 1

All About Discovery!New Mexico State University aces.nmsu.edu ™ Exercise Guidelines For Adults 150-minutes/week of moderate intensity Can talk while exercising, but not sing Or 75-minu

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All About Discovery!

New Mexico State University

aces.nmsu.edu

™

College of Agricultural, Consumer and Environmental Sciences

About the College: The College of Agricultural, Consumer and Environmental Sciences is an engine for economic and community development

in New Mexico, improving the lives of New Mexicans through academic, research, and extension programs.

The Impact of High-Intensity Interval Training and Resistance Training on

Diabetes Management and Implications for Practice

Dr Raquel Garzon, RDN

NMSU Cooperative Extension Services Nutrition and Wellness State Specialist

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New Mexico State University aces.nmsu.edu

™

Objectives

1 Understand the benefits of HIIT for people

with type 2 diabetes.

2 Understand the benefits of resistance

training for people with type 2 diabetes.

3 Be able to apply the science of HIIT and

resistance training to patients/clients with type 2 diabetes.

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™

Exercise Guidelines

For Adults

150-minutes/week of moderate intensity

Can talk while exercising, but not sing

Or 75-minutes/week of vigorous intensity

Can only say a few words at a time without pausing to catch your breath

2 sessions of resistance training per week

Work all major muscles, with 8-12 reps per set and progressive increases in intensity

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minimum not allowing

more than 2 days to go

between exercise

sessions

At least 150-minutes per week of moderate to vigorous physical

activity

Shorter durations of minutes per week of vigorous intensity interval training may be sufficient for younger, more fit individuals

3 or more minutes of light activity every 30- minutes during prolonged sedentary

activities

Colberg et al., 2016

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Exercise without sufficient intensity may not make a

significant difference to biochemical measures and fat loss

A combination of aerobic and resistance training may have enhanced benefits

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™

High Intensity Interval Training (HIIT)

Periods of vigorous exercise (>70% max) with periods of recovery

Colberg et al., 2016; Francois & Little, 2015

Protocols # Work

Intervals Duration Intensity

Recovery intervals

Differing protocols :

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aces.nmsu.edu

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HIIT vs Continuous Training

Superior results for HIIT:

Reductions in insulin resistance

Decreases in HbA1C Decreases in body weight and body fat mass

Increases in aerobic fitness (double) Decreases in fasting glucose levels Improvements in cardiac structure and function

Reductions in liver fat

Cassidy et al., 2016; Karstoft et al., 2013; Mitranum et al., 2014

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aces.nmsu.edu

™

Advantages of HIIT

Safe in: CAD, PAD, CHF, T2D, metabolic syndrome, asthma, obesity,

and older adults Improved endothelial function and blood pressure Increased muscle mitochondrial capacity, GLUT4 levels

Time commitment is lower for same or even better results

Less risk of hypoglycemia during and after exercise with vigorous

exercise as compared to moderate Improves glucose control acutely and over longer term Reductions in abdominal fat and increases in lower body muscle mass

Francois & Little, 2015; Little et al., 2011; Weston et al., 2014

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aces.nmsu.edu

™

Concerns with HIIT

ADA recommends a

12-lead ECG screening

for type 2 diabetics

before engaging in

vigorous exercise

Recommended that HIIT be supervised by a qualified exercise

specialist

Requirement to

increase vigor adequately in each

interval

Risk of musculoskeletal injuries with protocols

Colberg et al., 2016

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70-80%, then exhaustive 1RM

3-4 sets of 8-12 reps

70-80% 1RM

3 sets of 8 reps

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aces.nmsu.edu

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Insulin sensitivity

Type I muscle fibers: more insulin sensitive, greater oxidative capacity, higher capillary density

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(1RM)

Increased muscle quality (Strength per unit of muscle

mass)

Increased type I and II muscles

Decreased free

fatty acids reactive protein Decreased C- Increased serum adiponectin

Significant decreases in Insulin resistance (HOMA-IR)

Significant

decreases in

HbA1C Increased GLUT4

No change in fasting blood glucose

No change in insulin levels

Brooks et al., 2007; Dunstan et al., 2002; Holten et al., 2004

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Supervised high-intensity weight training resulted in significant decreases in HbA1C that were not maintained when doing home-based weight training

Resistance training + weight loss associated with three-fold decrease in HbA1C after 6 months compared with moderate weight loss without resistance training

Comparable to aerobic training in decreasing cardiac risk factors

A viable alternative for diabetics who cannot engage

in aerobic training

Dunstan et al., 2005; Lee et al., 2017

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aces.nmsu.edu

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Implications for Practice

Assess motivation, readiness, barriers, limitations, physical or medical factors, access, support

Provide basic understanding of HIIT/RT and potential positive impact

For some, shorter bouts of 5-10 minutes of HIIT-style exercise is more appealing and realistic than longer bouts of lower intensity, especially if getting more dramatic results or faster results

Offer actual HIIT and RT demonstration sessions in your organizations if equipped to do so or partner with a gym in which this experience can be offered

Get connected with a network of certified trainers that can help clients/patients get started

Walk the Talk Try HIIT and RT for yourself There is nothing like personal experience and results when you talk to others!

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References and Additional Reading

Adams, O P (2013) The impact of brief high-intensity exercise on blood glucose levels Diabetes, Metabolic Syndrome

and Obesity: Targets and Therapy, 6, 113-122

Brooks, N., Layne, J E., Gordon, P L., Roubenoff, R., Nelson, M E., & Castaneda-Sceppa, C (2007) Strength training

improves muscle quality and insulin sensitivity in Hispanic older adults with Type 2 diabetes International Journal of

Medical Sciences, 4(1), 19-27

Cassidy, S., Thoma, C., Hallsworth, K., Parikh, J., Hollingsworth, K G., Taylor, R.,…Trenell, M I (2016) High intensity intermittent exercise improves cardiac structure and function and reduces liver fat in patients with type 2 diabetes: A

randomized controlled study Diabetologia, 59, 59-66.

Colberg, S R., Sigal, R J., Yardley, J E., Riddell, M C., Dunstan, D W., Dempsey, P C.,…Tate, D F (2016) Physical

activity/exercise and diabetes: A position statement of the American Diabetes Association Diabetes Care, 39(11),

2065-2079

Dunstan, D W., Daly, R M., Owen, N, Jolley, D., Vulikh, E, Shaw, J, & Zimmel, P (2005) Home-based resistance training

is not sufficient to maintain improved glycemic control following supervised training in older individuals with Type 2

diabetes Diabetes Care, 28(1), 3-9.

Francois, M E., & Little, J P (2015) Effectiveness and safety of high-intensity training in patients with type 2 diabetes

Diabetes Spectrum, 28(1), 39-44

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aces.nmsu.edu

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Gibala, M J., Little, J P., MacDonald, M, J., & Hawley, J A (2012) Physiological adaptations to

low-volume, high-intensity interval training in health and disease Journal of Physiology, 590(5), 1077-1084.

Holten, M K., Zacho, M., Gaster, M., Juel, C., Wojtaszewski, J F P., & Dela, F (2004) Strength training increases insulin-mediated glucose uptake, GLUT4 content, and insulin signaling in skeletal muscle in

patients with Type 2 diabetes Diabetes, 53, 294-305.

Jelleyman, C., Yates, T., O’Donovan, G O., Gray, L J., King, J A.,…Davies, M J (2015) The effects of

high-intensity interval training on glucose regulation and insulin resistance: a meta-analysis Obesity Research, 16 (11), 942-961.

Karstoft, K., Winding, K, Knudsen, S H., Nielson, J S., Thomsen, C., Pedersen, B K., & Solomon, T P (2013) The effects of free-living interval-walking training on glycemic control, body composition, and

physical fitness in type 2 diabetic patients: a randomized, controlled trial Diabetes Care, 36(2), 228-236

Lee, J., Kim, D., & Kim, C (2017) Resistance training for glycemic control, muscular strength, and lean

body mass in old Type 2 diabetic patients: A meta-analysis Diabetes Therapy doi:

10.1007/s13300-017-0258-3

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Little, J P., Gillen, J B., Percival, M E., Safdar, A., Tarnopolsky, M A., Punthakee, Z.,…Gibala, M J (2011) Low-volume high-intensity interval training reduces hyperglycemia and increases muscle mitochondrial capacity in patients with type 2

diabetes Journal of Applied Physiology, 111(6), 1554-1560.

Mitranum, W., Deerochanawong, C., & Suksom, D (2014) Continuous vs interval training on glycemic control and

macro-and microvascular reactivity in type 2 diabetic patients Scmacro-andinavian Journal of Medicine & Science in Sports, 24(2),

69-76

Roberts, C K., Little, J P., & Thyfault, J P (2013) Modification of insulin sensitivity and glycemic control by activity and

exercise Medicine & Science in Sports & Exercise, 45(10), 1868-1877.

Shaban, N., Kenno, K., & Milne, K (2014) The effects of a 2 week modified high intensity interval training program on the

homeostatic model of insulin resistance (HOMA-IR) in adults with type 2 diabetes Journal of Sports Medicine and Physical

Fitness, 54, 203-209

Weston, K S., Wisloff, U., & Coombes, J S (2014) High-intensity interval training in patients with lifestyle-induced

cardiometabolic disease: A systematic review and meta-analysis British Journal of Sports Medicine, 48(16), 1227-1234.

Yang, Z., Scott, C A., Mao, C., Tang, J., & Farmer, A J (2014) Resistance training versus aerobic exercise for type 2

diabetes: A systematic review and meta-analysis Sports Medicine, 44(4), 487-499.

Zacker, R J (2005) Strength training in diabetes management Diabetes Spectrum, 18(2), 71-75.

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Envision New Mexico QI Staff Directory

Brandon Bell, MA.Ed

Health Education Consultant

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