To evaluate the effects of high-intensity interval training (HIIT) on cardiometabolic health-related outcomes in patients with type 2 diabetes mellitus and concurrent overweight/obesity (diabesity). Systematic review and meta-analysis of randomized controlled trials (RCTs). PubMed, Web of Science, Scopus, Science Direct, Cochrane Library, and Google Scholar databases were searched from inception up to January 31, 2025. RCTs comparing HIIT alone ≥ 2 weeks in duration with moderate-intensity continuous training (MICT). Participants were adults with diabesity. A total of 26 RCTs qualified, involving 790 patients (50/50 female/male ratio; age: 59.8 ± 12.9 years; body mass index: 28.9 ± 4.2 kg/m2). HIIT revealed a significant reduction in fasting insulin [standardized mean differences (SMD) − 0.43, 95% CI − 0.82 to − 0.05] and homeostatic model assessment for insulin resistance (HOMA-IR; SMD − 0.52, 95% CI − 0.97 to − 0.07) compared to MICT. Additionally, HIIT significantly increased cardiorespiratory fitness (VO₂max; SMD 0.53, 95% CI 0.14 to 0.91) compared to MICT. Other clinically relevant cardiometabolic outcomes, including body composition, lipid profile, fasting blood glucose, glycated hemoglobin, and blood pressure, showed comparable changes between HIIT and MICT. Subgroup analyses of studies reporting comorbidities indicated a significant increase in high-density lipoprotein cholesterol (SMD 0.49, 95% CI 0.04 to 0.95) and a decrease in HOMA-IR (SMD − 0.83, 95% CI − 1.62 to − 0.04) for HIIT compared to MICT. However, these findings are limited by very low certainty evidence and non-robust sensitivity analyses. The present findings suggest that HIIT may serve as an adjunctive non-pharmaceutical management solution for patients with diabesity. Open Science Framework registry: https://osf.io/9by24

This systematic review and meta-analysis aimed to evaluate the effects of high-intensity interval training (HIIT) on cardiometabolic health-related outcomes in patients with type 2 diabetes and obesity (diabesity). PubMed, Web of Science, Scopus, Science Direct, Cochrane Library, and Google Scholar databases were searched from inception up to November 2024. The search strategy encompassed the following keywords: diabetes, obesity, and HIIT. Randomized controlled trials (RCTs) recruiting adult participants with diabesity and comparing HIIT per se for ≥ 2 weeks in duration with non-exercise standard treatment were included. A total of 18 RCTs qualified involving 504 patients (52/48 women/men ratio; 55.0 ± 11.8 years; 31.0 ± 6.9 kg/m2). Body mass [standardized mean differences (SMD) -0.36 kg, 95% confidence intervals (CI) -0.71 to -0.01], body mass index (SMD -0.57 kg/m2, 95% CI -0.92 to -0.21), waist-to-hip ratio (SMD -1.68, 95% CI -2.50 to -0.86), fasting blood glucose (SMD -0.64 mmol/L, 95% CI -1.03 to -0.24), glycated hemoglobin (SMD -1.08%, 95% CI -1.68 to -0.47), fasting insulin (SMD -0.79 mIU/L, 95% CI -1.28 to -0.31), homeostatic model assessment for insulin resistance (SMD -0.95, 95% CI -1.43 to -0.47), low-density lipoprotein cholesterol (SMD -0.64 mg/dL, 95% CI -1.23 to -0.06), triglycerides (SMD -0.64 mg/dL, 95% CI -1.02 to -0.26), and total cholesterol (SMD -0.66 mg/dL, 95% CI -1.23 to -0.08) improved compared to standard treatment without exercise. The present findings suggest that HIIT improves several markers of metabolic health and cardiovascular risk, even without significant body composition improvements in patients with diabesity. https://osf.io/rtb42

Background: The potential advantages of concurrent aerobic and resistance training (CART) for enhancing cardiometabolic health-related outcomes appear to surpass the outcomes of engaging in aerobic or resistance training alone. The present study aimed to synthesize the available scientific evidence on the effects of CART on body composition, lipid metabolism, and physical function in patients with type 2 diabetes and overweight/obesity. Methods: PubMed, Scopus, ScienceDirect, Cochrane Library, and Google Scholar were searched from inception to August 7, 2024. The review focused on randomized controlled trials and controlled clinical trials of CART. The Cochrane risk of bias tool was used to assess eligible studies, and the GRADE method to evaluate the reliability of evidence. A random-effects model was used and data were analyzed using standardized mean differences (SMD) and 95% confidence intervals (CI). Results: A total of 22,878 studies were retrieved; only 20 studies were included, and data were extracted from 1,289 participants (57.0 ± 7.0 years; 31.1 ± 4.6 kg/m²) who met the eligibility criteria. CART group significantly reduced body fat percentage (SMD −0.42, 95% CI [−0.70 to −0.15]), low-density lipoprotein-cholesterol (SMD −0.32, 95% CI [−0.62 to −0.02]), triglycerides (SMD −0.48, 95% CI [−0.71 to −0.24]), total cholesterol (SMD −0.35, 95% CI [−0.58 to −0.12]), and fasting blood glucose levels compared to standard treatment (non-exercising controls). CART significantly increased high-density lipoprotein-cholesterol (SMD 0.44, 95% CI [0.05–0.82]) and improved physical function (cardiorespiratory fitness: SMD 78.78, 95% CI [46.30–111.25]; muscular fitness: SMD 5.19, 95% CI [1.80–8.59]) compared to standard treatment. There were no significant differences in body mass, waist-to-hip ratio, fat mass, and lean body mass between CART and standard treatment. An uncertain risk of bias and poor quality of evidence were observed in the eligible studies. Conclusions: The present results indicate clear evidence that CART has a beneficial role in the improvement of several cardiometabolic health-related parameters in patients with type 2 diabetes and concomitant overweight/obesity. More trials with robust methodological design are needed to investigate the dose-response effects, training parameters formation, and potential mechanisms.

This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to evaluate the effects of aerobic exercise on cardiometabolic health-related indices in patients with type 2 diabetes and concurrent overweight/obesity (diabesity). PubMed, Web of Science, Scopus, Science Direct, Cochrane Library, and Google Scholar databases were searched from inception to October 2024. The search strategy included the following keywords: diabetes, aerobic exercise, and endurance training. RCTs comparing aerobic exercise training ≥2 weeks in duration to standard treatment were considered eligible. Participants were adults with diabesity. A total of 1391 middle-aged/older adult patients (55 % females) were included in 34 RCTs. Body mass index [standardized mean differences (SMD) -0.18 kg/m², 95 % confidence intervals (CI) -0.36 to -0.01]. waist circumference (SMD -0.23 cm, 95 % CI -0.44 to -0.03), body fat (SMD -0.30 %, 95 % CI -0.59 to -0.01), fasting blood glucose (SMD -0.49 mmol/L, 95 % CI -0.72 to -0.27), glycated hemoglobin (SMD -0.79 %, 95 % CI -1.17 to -0.41), fasting insulin (SMD -0.44 mIU/L, 95 % CI -0.72 to -0.15), homeostatic model assessment for insulin resistance (SMD -0.72, 95 % CI -1.09 to -0.35), high-density lipoprotein cholesterol (SMD 0.32 mg/dL, 95 % CI 0.01 to 0.63), triglycerides (SMD -0.33 mg/dL, 95 % CI -0.63 to -0.04), and total cholesterol (SMD -0.28 mg/dL, 95 % CI -0.47 to -0.10) improved compared with standard treatment. These results underscore the beneficial role of aerobic exercise as a non-pharmacological intervention in managing and treating patients with diabesity when compared to standard treatment, despite the presence of considerable uncertainty in several outcomes.

Background: Obese subjects are at risk of multiple comorbidities including stroke and coronary heart disease (CHD), which is partly due to disturbances in the hemostatic system. Aims: The aims of the present study were to determine the effects of a weight-loss program on fibrinogen and fibrinolytic markers. Materials and Methods: Twenty-eight obese subjects were involved in a weight-loss program consisted of exercise and nutritional education for 12-weeks duration. Physical parameters were documented and blood specimen was tested at pre and post-intervention for fibrinogen, tissue plasminogen activator (t-PA), plasminogen activator inhibitor-1 (PAI-1), and thrombin activatable fibrinolysis inhibitor (TAFI). Paired t-test was used for statistical analysis. Results: There was a significant decline in the levels of t-PA, PAI-I, TAFI and fibrinogen following the weight-loss program (P < 0.01 for each). A significant positive correlation between tPA levels and body weight, body mass index (BMI), waist circumference, and fat-free mass were found. There was also a significant correlation betwen BMI and other blood parameters. Conclusion: Reduced fibrinogen, fibrinolytic, and physical parameters were demonstrated in obese subjects following the weight reduction program. These findings suggest the possible beneficial effects of this program on the hemostatic burden particularly on the fibrinolytic biomarkers.

Photoplethysmogram (PPG) is a non-invasive optical technique that is widely used in many cardiovascular risk assessment and monitoring applications. PPG is the measure of blood volume change recorded from finger, toe, ear lobe, forehead and other location based on the application requirements. PPG has been adopted as a potential non-invasive technique for lipid profiling among young men aged between 20 - 40 years old. A total of 76 subjects were recruited from a non-active lifestyle with less than five thousand steps a day in walking with cardiovascular risk which includes two or more cardiovascular risks factor. The parameter measurements that were taken in the study were the finger PPG signal recording and the cholesterol values which were the HDL, LDL and triglyceride (TG). The morphological analysis clearly differentiates the subjects with different combination of lipid profiles. In this study we are able to categorize subjects into four different groups: a) normal LDL: normal TG; b) high LDL: normal TG; c) normal LDL: high TG; d) high LDL: high TG. The identified morphological classification will need further analysis and automated classification to establish a non-invasive low cost optical based screening method for lipid profiling in future.