Abstract / Summary
Type 2 diabetes (T2D) is characterized by chronic hyperglycemia and marked within-day glucose fluctuations. Compared with conventional glycemic markers, continuous glucose monitoring (CGM)-derived metrics provide complementary information on overall glycemic exposure, postprandial responses, and glycemic variability. Although high-intensity interval training (HIIT) has shown promise for improving glycemic control in T2D, its effects on CGM-derived outcomes have not been systematically synthesized. To systematically review and meta-analyze the effects of HIIT on CGM-derived glycemic outcomes in adults with T2D, compared with non-exercise control (CON) or other exercise interventions. PubMed, Embase, Web of Science, the Cochrane Library, and EBSCOhost were searched from inception to January 26, 2026. Interventional studies comparing HIIT with CON or other exercise interventions and reporting CGM-derived outcomes were included. When data were suitable for quantitative pooling, pooled estimates were calculated from change-from-baseline values using fixed- or random-effects models. Risk of bias was assessed using RoB 2, RoB 2 for crossover trials, or ROBINS-I, and certainty of evidence was evaluated with GRADE. Twelve studies involving 177 participants were included. Compared with CON, HIIT reduced 24-hour mean glucose, postprandial glucose, and time spent in hyperglycemia, while its effect on mean amplitude of glycemic excursions (MAGE) remained uncertain. Compared with moderate-intensity continuous training (MICT), HIIT further reduced 24-hour mean glucose and time spent in hyperglycemia, but no significant between-group difference was found for MAGE. Overall certainty of evidence ranged from very low to low. HIIT may improve selected CGM-derived glycemic outcomes in adults with T2D, particularly postprandial glucose and hyperglycemic exposure. Compared with MICT, HIIT may offer additional benefits for reducing 24-hour mean glucose and hyperglycemic time. However, confidence in these findings is limited by the small number of studies, methodological limitations, and heterogeneity.
Primary Source
Frontiers in endocrinology
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