Effects of high-intensity interval training and moderate-intensity continuous training on type 2 diabetes mellitus: a meta-analysis and systematic review.

UNLABELLED: This meta-analysis compared the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on type 2 diabetes (T2DM). A systematic search of the PubMed, Web of Science, Cochrane Library and Embase databases (from the inception of each database to 16 November 2025) identified a total of 21 randomized controlled trials involving 792 participants. A pooled analysis was conducted using standardized mean differences (SMD) and 95% confidence intervals. The results showed no significant differences between HIIT and MICT in terms of glycated hemoglobin (HbA1c), fasting blood glucose, HOMA-IR, body mass index (BMI), total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL) or blood pressure. However, HIIT demonstrated a significant advantage in improving high-density lipoprotein cholesterol (HDL) (SMD 0.44, p = 0.023). Subgroup analyses indicated that moderate training duration (20-30 minutes), lower weekly training frequency (≤3 sessions) and shorter intervention duration (≤8 weeks) optimized the benefits of HIIT on HDL. These findings suggest that HIIT is an effective alternative to MICT for patients with type 2 diabetes, particularly those with time constraints and whose primary metabolic abnormality is characterized by low HDL levels. Personalized exercise prescriptions should consider training duration and weekly training frequency as key modifiers.

SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD420261343976.