{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T06:21:22Z","timestamp":1783405282924,"version":"3.54.6"},"reference-count":55,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:p>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\u201330 minutes), lower weekly training frequency (\u22643 sessions) and shorter intervention duration (\u22648 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.<\/jats:p>\n                  <jats:sec>\n                    <jats:title>Systematic review registration:<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/<\/jats:ext-link>\n                      , identifier CRD420261343976\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1876685","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T05:48:18Z","timestamp":1783403298000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of high-intensity interval training and moderate-intensity continuous training on type 2 diabetes mellitus: a meta-analysis and systematic review"],"prefix":"10.3389","volume":"17","author":[{"given":"Fan","family":"Zeng","sequence":"first","affiliation":[{"name":"School of Leisure Sports and Tourism, Beijing Sport University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengke","family":"Zhu","sequence":"additional","affiliation":[{"name":"School of Leisure Sports and Tourism, Beijing Sport University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Yang","sequence":"additional","affiliation":[{"name":"School of Leisure Sports and Tourism, Beijing Sport University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatao","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Leisure Sports and Tourism, Beijing Sport University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","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":"Sun","year":"2022","journal-title":"Diabetes Res Clin Pract"},{"key":"B2","doi-asserted-by":"publisher","first-page":"3434","DOI":"10.1186\/s12889-025-24491-5","article-title":"Impact of education level on complications and mortalities in type 2 diabetes: A UK Biobank prospective cohort study","volume":"25","author":"Luo","year":"2025","journal-title":"BMC Public Health"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1111\/dom.16220","article-title":"Efficacy of high-intensity interval training in individuals with type 2 diabetes mellitus: an umbrella review of systematic reviews and meta-analyses","volume":"27","author":"Poon","year":"2025","journal-title":"Diabetes Obes Metab"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.2337\/dc12-0658","article-title":"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","volume":"36","author":"Karstoft","year":"2013","journal-title":"Diabetes Care"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.2337\/dc24-0864","article-title":"Comprehensive multiple risk factor control in type 2 diabetes to mitigate heart failure risk: insights from a prospective cohort study","volume":"47","author":"Huang","year":"2024","journal-title":"Diabetes Care"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.2337\/dc16-1728","article-title":"Physical activity\/exercise and diabetes: A position statement of the American Diabetes Association","volume":"39","author":"Colberg","year":"2016","journal-title":"Diabetes Care"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0000000000002800","article-title":"Exercise\/physical activity in individuals with type 2 diabetes: a consensus statement from the American College of Sports Medicine","volume":"54","author":"Kanaley","year":"2022","journal-title":"Med Sci Sports Exerc"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph16214163","article-title":"High-intensity interval training versus moderate-intensity continuous training in middle-aged and older patients with type 2 diabetes: A randomized controlled crossover trial of the acute effects of treadmill walking on glycemic control","volume":"16","author":"Mendes","year":"2019","journal-title":"Int J Environ Res Public Health"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1136\/bmjsem-2024-002046","article-title":"Low-volume combined aerobic and resistance high-intensity interval training in type 2 diabetes: A randomised controlled trial","volume":"10","author":"Gajanand","year":"2024","journal-title":"BMJ Open Sport Exercise Med"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1093\/heapro\/dap031","article-title":"Barriers to regular exercise among adults at high risk or diagnosed with type 2 diabetes: A systematic review","volume":"24","author":"Korkiakangas","year":"2009","journal-title":"Health Promotion Int"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1553","DOI":"10.1186\/s12889-025-22816-y","article-title":"Level of adherence to physical activity recommendations among adults with type 2 diabetes in Qatar and associated factors: A cross-sectional study","volume":"25","author":"Boutefnouchet","year":"2025","journal-title":"BMC Public Health"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2013-092576","article-title":"High-intensity interval training in patients with lifestyle-induced cardiometabolic disease: A systematic review and meta-analysis","volume":"48","author":"Weston","year":"2014","journal-title":"Br J Sports Med"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1152\/ajpendo.00407.2016","article-title":"Functional high-intensity training improves pancreatic \u03b2-cell function in adults with type 2 diabetes","volume":"313","author":"Nieuwoudt","year":"2017","journal-title":"Am J Physiol Endocrinol Metab"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-022-05674-w","article-title":"High-intensity interval training for 12 weeks improves cardiovascular autonomic function but not somatosensory nerve function and structure in overweight men with type 2 diabetes","volume":"65","author":"B\u00f6nhof","year":"2022","journal-title":"Diabetologia"},{"key":"B15","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1186\/s13643-025-02772-9","article-title":"Effect of exercise training on cardiac autonomic function in type 2 diabetes mellitus: a systematic review and meta-analysis","volume":"14","author":"Raje","year":"2025","journal-title":"Syst Rev"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2024.1360998","article-title":"Effects of high-intensity intermittent exercise on glucose and lipid metabolism in type 2 diabetes patients: A systematic review and meta-analysis","volume":"15","author":"Feng","year":"2024","journal-title":"Front Endocrinol"},{"key":"B17","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1186\/s13102-023-00777-2","article-title":"Home-based high-intensity interval training improves cardiorespiratory fitness: a systematic review and meta-analysis","volume":"15","author":"Tsuji","year":"2023","journal-title":"BMC Sports Sci Med Rehabil"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2025.1614149","article-title":"Effect of high-intensity interval training and moderate-intensity continuous training on body composition, glycolipid metabolism, and cardiopulmonary function in patients with pre-diabetes: A randomized controlled trial","volume":"16","author":"Chen","year":"2025","journal-title":"Front Endocrinol"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.12965\/jer.1836648.324","article-title":"Moderate-intensity continuous training: Is it as good as high-intensity interval training for glycemic control in type 2 diabetes","volume":"15","author":"Ahmad","year":"2019","journal-title":"J Exercise Rehabil"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-009-1354-3","article-title":"Continuous low- to moderate-intensity exercise training is as effective as moderate- to high-intensity exercise training at lowering blood HbA(1c) in obese type 2 diabetes patients","volume":"52","author":"Hansen","year":"2009","journal-title":"Diabetologia"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0210644","article-title":"Effects of HIIT and MICT on cardiovascular risk factors in adults with overweight and\/or obesity: A meta-analysis","volume":"14","author":"Su","year":"2019","journal-title":"PloS One"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2024.1347399","article-title":"The effect of exercise on flow-mediated dilation in people with type 2 diabetes mellitus: A systematic review and meta-analysis of randomized controlled trials","volume":"15","author":"Qiu","year":"2024","journal-title":"Front Endocrinol"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d5928","article-title":"The Cochrane collaboration\u2019s tool for assessing risk of bias in randomised trials","volume":"343","author":"Higgins","year":"2011","journal-title":"BMJ"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.3390\/life14081011","article-title":"Effects of exercise on cancer-related fatigue in breast cancer patients: A systematic review and meta-analysis of randomized controlled trials","volume":"14","author":"Zhou","year":"2024","journal-title":"Life"},{"key":"B26","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1002\/jrsm.12","article-title":"A basic introduction to fixed-effect and random-effects models for meta-analysis","volume":"1","author":"Borenstein","year":"2010","journal-title":"Res Synth Methods"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2024.1387658","article-title":"Effects of exercise in people with multiple sclerosis: A systematic review and meta-analysis","volume":"12","author":"Du","year":"2024","journal-title":"Front Public Health"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2012.10.019","article-title":"Feasibility and preliminary efficacy of high intensity interval training in type 2 diabetes","volume":"99","author":"Terada","year":"2013","journal-title":"Diabetes Res Clin Pract"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7109.629","article-title":"Bias in meta-analysis detected by a simple, graphical test","volume":"315","author":"Egger","year":"1997","journal-title":"BMJ"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1016\/j.dsx.2021.102233","article-title":"Low-volume walking HIIT: Efficient strategy to improve physical capacity and reduce the risk of cardiovascular disease in older women with type 2 diabetes","volume":"15","author":"Marcotte-Ch\u00e9nard","year":"2021","journal-title":"Diabetes Metab Syndrome"},{"key":"B31","doi-asserted-by":"publisher","first-page":"72","DOI":"10.3390\/Obesities1020007","article-title":"Acute and chronic effects of low-volume high-intensity interval training compared to moderate-intensity continuous training on glycemic control and body composition in older women with type 2 diabetes","volume":"1","author":"Marcotte-Ch\u00e9nard","year":"2021","journal-title":"Obesities"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1113\/EP087005","article-title":"Improved brachial artery shear patterns and increased flow-mediated dilatation after low-volume high-intensity interval training in type 2 diabetes","volume":"103","author":"Ghardashi","year":"2018","journal-title":"Exp Physiol"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.2337\/dc19-2523","article-title":"The effect of a novel low-volume aerobic exercise intervention on liver fat in type 2 diabetes: A randomized controlled trial","volume":"43","author":"Sabag","year":"2020","journal-title":"Diabetes Care"},{"key":"B34","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1016\/j.exger.2018.12.013","article-title":"Effect of all-extremity high-intensity interval training vs. moderate-intensity continuous training on aerobic fitness in middle-aged and older adults with type 2 diabetes: A randomized controlled trial","volume":"116","author":"Hwang","year":"2019","journal-title":"Exp Gerontology"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1007\/s00421-024-05473-8","article-title":"Effect of low-volume combined aerobic and resistance high-intensity interval training on vascular health in people with type 2 diabetes: A randomised controlled trial","volume":"124","author":"Cox","year":"2024","journal-title":"Eur J Appl Physiol"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph19052601","article-title":"HIIE protocols promote better acute effects on blood glucose and pressure control in people with type 2 diabetes than continuous exercise","volume":"19","author":"Teles","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1080\/17461391.2023.2167238","article-title":"Is isoenergetic high-intensity interval exercise superior to moderate-intensity continuous exercise for cardiometabolic risk factors in individuals with type 2 diabetes mellitus? A single-blinded randomized controlled study","volume":"23","author":"Findikoglu","year":"2023","journal-title":"Eur J Sport Sci"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1111\/dom.13551","article-title":"Effectiveness of high-intensity interval training combined with resistance training versus continuous moderate-intensity training combined with resistance training in patients with type 2 diabetes: A one-year randomized controlled trial","volume":"21","author":"Magalh\u00e3es","year":"2019","journal-title":"Diabetes Obes Metab"},{"key":"B39","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1186\/s12933-019-0840-2","article-title":"Effects of combined training with different intensities on vascular health in patients with type 2 diabetes: A 1-year randomized controlled trial","volume":"18","author":"Magalh\u00e3es","year":"2019","journal-title":"Cardiovasc Diabetol"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2020.06.019","article-title":"The effect of low-volume high-intensity interval training on cardiovascular health outcomes in type 2 diabetes: A randomised controlled trial","volume":"320","author":"Way","year":"2020","journal-title":"Int J Cardiol"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2023.985404","article-title":"The effects of three different low-volume aerobic training protocols on cardiometabolic parameters of type 2 diabetes patients: A randomized clinical trial","volume":"14","author":"Gentil","year":"2023","journal-title":"Front Endocrinol"},{"key":"B42","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1007\/s40200-025-01713-6","article-title":"Feasibility and preliminary effects of high-intensity interval training vs. moderate-intensity continuous training on inflammatory and metabolic biomarkers in type 2 diabetes: A pilot randomized controlled trial","volume":"24","author":"Alizadeh","year":"2025","journal-title":"J Diabetes Metab Disord"},{"key":"B43","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1080\/08977194.2023.2279163","article-title":"The effects of 12 weeks of high-intensity interval training and moderate-intensity continuous training on FGF21, irisin, and myostatin in men with type 2 diabetes mellitus","volume":"42","author":"Riahy","year":"2024","journal-title":"Growth Factors"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1055\/a-1027-6511","article-title":"The effect of high-intensity interval training on physical parameters, metabolomic indexes and serum ficolin-3 levels in patients with prediabetes and type 2 diabetes","volume":"129","author":"Liu","year":"2021","journal-title":"Exp Clin Endocrinol Diabetes: Off Journal German Soc Endocrinol [and] German Diabetes Assoc"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/9273830","article-title":"A comparative study of health efficacy indicators in subjects with T2DM applying power cycling to 12 weeks of low-volume high-intensity interval training and moderate-intensity continuous training","volume":"2022","author":"Li","year":"2022","journal-title":"J Diabetes Res"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbmt.2024.12.013","article-title":"The impact of two different aerobic exercise intensities on cardiometabolic parameters in type 2 diabetic patients: A randomized trial","volume":"42","author":"Costa-Arruda","year":"2025","journal-title":"J Bodywork Movement Therapies"},{"key":"B47","article-title":"The effects of eight weeks high-intensity interval training vs. continuous moderate-intensity training on plasma dickkopf-1 and glycemic control in patients with type 2 diabetes","volume":"8","author":"Saghand","year":"2020","journal-title":"Ann Appl Sport Sci"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.4172\/2155-6156.1000418","article-title":"Effects of supervised short-term exercise training on cardiorespiratory control and exercise capacity in type 2 diabetes patients","volume":"5","author":"Duennwald","year":"2014","journal-title":"J Diabetes Metab"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.1016\/j.jlr.2026.100993","article-title":"Characterization and response to exercise training of HDL-specific phospholipid efflux","volume":"67","author":"Leszczynski","year":"2026","journal-title":"J Lipid Res"},{"key":"B50","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines9070729","article-title":"HDL dysfunctionality: Clinical relevance of quality rather than quantity","volume":"9","author":"Bonizzi","year":"2021","journal-title":"Biomedicines"},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2023.1170324","article-title":"Elucidating the primary mechanisms of high-intensity interval training for improved cardiac fitness in obesity","volume":"14","author":"Bo","year":"2023","journal-title":"Front Physiol"},{"key":"B52","doi-asserted-by":"publisher","DOI":"10.3390\/ijms27083475","article-title":"Canonical and alternative pathways (insulin and exercise) of GLUT4 synthesis, signaling, intracellular clustering, and recruitment to the plasma membrane","volume":"27","author":"Ramos-Jim\u00e9nez","year":"2026","journal-title":"Int J Mol Sci"},{"key":"B53","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1161\/01.cir.79.1.8","article-title":"High-density lipoprotein cholesterol and cardiovascular disease. Four prospective American studies","volume":"79","author":"Gordon","year":"1989","journal-title":"Circulation"},{"key":"B54","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1002\/jrsm.1160","article-title":"Get real in individual participant data (IPD) meta-analysis: A review of the methodology","volume":"6","author":"Debray","year":"2015","journal-title":"Res Synth Methods"},{"key":"B55","doi-asserted-by":"publisher","DOI":"10.1017\/S0266462312000086","article-title":"The effect of English-language restriction on systematic review-based meta-analyses: a systematic review of empirical studies","volume":"28","author":"Morrison","year":"2012","journal-title":"Int J Technol Assess Health Care"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1876685\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T05:48:19Z","timestamp":1783403299000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1876685\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,7]]},"references-count":55,"alternative-id":["10.3389\/fendo.2026.1876685"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2026.1876685","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,7]]},"article-number":"1876685"}}