{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T11:54:05Z","timestamp":1793188445259,"version":"4.5.0"},"reference-count":46,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T00:00:00Z","timestamp":1765324800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"\n Background<\/jats:title>\n Exercise training is a cornerstone in managing type 2 diabetes mellitus (T2DM), yet direct comparisons between combined aerobic\u2013resistance training (A\u2009+\u2009R) and high-intensity interval training (HIIT) across clinical and patient-reported outcomes remain limited.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To compare the effects of A\u2009+\u2009R and HIIT on insulin resistance, glycaemic control, body composition, physical function, and quality of life in adults with T2DM, relative to standard care.<\/jats:p>\n <\/jats:sec>\n \n Design and participants<\/jats:title>\n A single-centre, randomised controlled trial involving 90 participants with T2DM (aged 30\u201365 years), allocated to A\u2009+\u2009R, HIIT, or control groups.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n A\u2009+\u2009R consisted of moderate-intensity aerobic and resistance exercises, while HIIT comprised structured interval sessions. Both programs were delivered 3\u20135 times weekly for 12 weeks. The control group received usual care without structured exercise.<\/jats:p>\n <\/jats:sec>\n \n Measurements<\/jats:title>\n Primary outcomes included fasting insulin (FI), Glycosylated Hemoglobin (HbA1c), and insulin resistance (HOMA-IR). Secondary outcomes included fasting glucose (FG), 6-minute walk distance (6MWD), subcutaneous and visceral fat, muscle mass, and WHOQOL-BREF domains.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Compared with control, the HIIT group showed a greater reduction in fasting glucose (Mean Difference [MD] \u221229.1 mg\/dL; 95% CI \u221241.2 to \u221217.0) and the A+R group also improved (MD \u221220.6 mg\/dL; 95% CI \u221231.0 to \u221210.2). HbA1c was lower versus control in both HIIT (MD \u22123.35%; 95% CI \u22124.11 to \u22122.58) and A+R (MD \u22123.33%; 95% CI \u22124.03 to \u22122.62). Fasting insulin decreased relative to control in HIIT (MD \u22127.16 mIU\/L; 95% CI \u221210.04 to \u22124.28) and A+R (MD \u22128.87 mIU\/L; 95% CI \u221211.77 to \u22125.97). HOMA-IR improved versus control in A+R (MD \u22122.33; 95% CI \u22123.63 to \u22121.03) with a non-significant trend in HIIT (MD \u22121.17; 95% CI \u22122.47 to 0.13). Functional capacity (6-minute walk distance) increased versus control in HIIT (MD +178.9 m; 95% CI 130.5 to 227.4) and A+R (MD +233.6 m; 95% CI 191.8 to 275.5). Body composition favored both interventions: fat-free mass increased (HIIT MD +7.54 kg; 95% CI 4.71 to 10.36; A+R MD +5.96 kg; 95% CI 3.06 to 8.86) while subcutaneous fat (HIIT MD \u22127.16%; 95% CI \u22129.33 to \u22124.99; A+R MD \u22128.37%; 95% CI \u221210.65 to \u22126.09) and visceral fat (HIIT MD \u22124.70%; 95% CI \u22125.93 to \u22123.47; A+R MD \u22124.58%; 95% CI \u22125.86 to \u22123.31) were reduced. Quality of life improved across domains versus control in both groups (e.g., physical domain: HIIT MD +10.29; 95% CI 4.06 to 16.51; A+R MD +13.77; 95% CI 6.62 to 20.91). All results were derived from covariate-adjusted mixed models with multiple comparison corrections (Benjamini\u2013Hochberg FDR, q = 0.05; Bonferroni-adjusted \u03b1 = 0.002).<\/jats:p>\n <\/jats:sec>\n \n Limitations<\/jats:title>\n Findings are limited to adherent participants, and generalizability is restricted to those without advanced complications. The 12-week duration precludes assessment of long-term sustainability.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Both HIIT and A+R significantly improved metabolic, functional, and psychosocial outcomes compared with control. HIIT yielded greater benefits for fasting glucose and muscle mass, while A+R conferred broader improvements in HbA1c, fat reduction, and quality of life. These findings support tailoring exercise prescriptions to therapeutic goals and highlight the complementary roles of HIIT and A+R in routine diabetes care.<\/jats:p>\n <\/jats:sec>\n \n Clinical trial registration<\/jats:title>\n The trial is registered with the Clinical Trial Registry of India (reference no: CTRI\/2022\/04\/041762).<\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pone.0336898","type":"journal-article","created":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T18:22:11Z","timestamp":1765390931000},"page":"e0336898","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Comparative effects of combined aerobic and resistance training versus high-intensity interval training on insulin resistance, glycaemic control, body composition and quality of life in type 2 diabetes: A 12-week randomised controlled trial"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4744-0180","authenticated-orcid":true,"given":"Sampath Kumar","family":"Amaravadi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7014-2002","authenticated-orcid":true,"given":"Arthur de S\u00e1","family":"Ferreira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6097-1456","authenticated-orcid":true,"given":"Patr\u00edcia dos Santos","family":"Vig\u00e1rio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,12,10]]},"reference":[{"key":"pone.0336898.ref001","doi-asserted-by":"crossref","first-page":"109119","DOI":"10.1016\/j.diabres.2021.109119","article-title":"IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045","volume":"183","author":"H Sun","year":"2022","journal-title":"Diabetes Res Clin Pract"},{"key":"pone.0336898.ref002","volume-title":"IDF Diabetes Atlas","author":"International Diabetes Federation","year":"2025"},{"key":"pone.0336898.ref003","article-title":"3. 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