Effects of high-intensity interval training, moderate-intensity continuous training, and guideline-based physical activity on cardiovascular metabolic markers, cognitive and motor function in elderly sedentary patients with type 2 diabetes (HIIT-DM): a protocol for a randomized controlled trial

Peng Yu; Zicheng Zhu; Jiahui He; Bohua Gao; Qi Chen; Yifan Wu; Jing Zhou; Yixuan Cheng; Jitao Ling; Jing Zhang; Ao Shi; Huijing Huang; Runlu Sun; Yan Gao; Weiguang Li; Xiao Liu; Zhiwei Yan

doi:10.3389/fnagi.2023.1211990

Effects of high-intensity interval training, moderate-intensity continuous training, and guideline-based physical activity on cardiovascular metabolic markers, cognitive and motor function in elderly sedentary patients with type 2 diabetes (HIIT-DM): a protocol for a randomized controlled trial

Front Aging Neurosci. 2023 Aug 15:15:1211990. doi: 10.3389/fnagi.2023.1211990. eCollection 2023.

Authors

Peng Yu^#^{1

2}, Zicheng Zhu^#¹, Jiahui He³, Bohua Gao⁴, Qi Chen⁵, Yifan Wu³, Jing Zhou³, Yixuan Cheng³, Jitao Ling³, Jing Zhang⁶, Ao Shi^{7

8}, Huijing Huang³, Runlu Sun^{9

10}, Yan Gao¹¹, Weiguang Li¹², Xiao Liu^{9

10}, Zhiwei Yan^{11

13}

Affiliations

¹ Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
² Institute for the Study of Endocrinology and Metabolism in Jiangxi Province, Nanchang, Jiangxi, China.
³ The Second Clinical Medical College of Nanchang University, Nanchang, Jiangxi, China.
⁴ School of Basic Medicine, Fujian Medical University, Fuzhou, China.
⁵ Laboratory of Exercise Physiology, Liaoning Province Sports Development Center, Shenyang, Liaoning, China.
⁶ Department of Anesthesiology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
⁷ St. George's University of London, London, United Kingdom.
⁸ School of Medicine, University of Nicosia, Nicosia, Cyprus.
⁹ Department of Cardiology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China.
¹⁰ Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, Guangdong, China.
¹¹ College of Kinesiology, Shenyang Sport University, Shenyang, Liaoning, China.
¹² Cardiology Department, Liaoning Province Jinqiu Hospital, Shenyang, Liaoning, China.
¹³ Provincial University Key Laboratory of Sport and Health Science, School of Physical Education and Sport Sciences, Fujian Normal University, Fuzhou, Fujian, China.

^# Contributed equally.

Abstract

Background and objective: Sedentary behavior is of increasing concern in older patients with type 2 diabetes mellitus (T2DM) due to its potential adverse effects on cardiovascular health, cognitive function, and motor function. While regular exercise has been shown to improve the health of individuals with T2DM, the most effective exercise program for elderly sedentary patients with T2DM remains unclear. Therefore, the objective of this study was to assess the impact of high-intensity interval training (HIIT), moderate-intensity continuous training (MICT), and guideline-based physical activity programs on the cardiovascular health, cognitive function, and motor function of this specific population.

Methods: This study will be a randomized, assessor-blind, three-arm controlled trial. A total of 330 (1:1:1) elderly sedentary patients diagnosed with T2DM will be randomly assigned the HIIT group (10 × 1-min at 85-95% peak HR, intersperse with 1-min active recovery at 60-70% peak HR), MICT (35 min at 65-75% peak HR), and guideline-based group (guideline group) for 12 weeks training. Participants in the guideline group will receive 1-time advice and weekly remote supervision through smartphones. The primary outcomes will be the change in glycosylated hemoglobin (HbA1c) and brain-derived neurotrophic factor (BDNF) after 12-weeks. Secondary outcomes will includes physical activity levels, anthropometric parameters (weight, waist circumference, hip circumference, and body mass index), physical measurements (fat percentage, muscle percentage, and fitness rate), cardiorespiratory fitness indicators (blood pressure, heart rate, vital capacity, and maximum oxygen), biochemical markers (high-density lipoprotein, low-density lipoprotein, triglycerides, total cholesterol, and HbA1c), inflammation level (C-reactive protein), cognitive function (reaction time and dual-task gait test performance), and motor function (static balance, dynamic balance, single-task gait test performance, and grip strength) after 12 weeks.

Discussion: The objective of this study is to evaluate the effect of 12 weeks of HIIT, MICT, and a guideline-based physical activity program on elderly sedentary patients diagnosed with T2DM. Our hypothesis is that both HIIT and MICT will yield improvements in glucose control, cognitive function, cardiopulmonary function, metabolite levels, motor function, and physical fitness compared to the guideline group. Additionally, we anticipate that HIIT will lead to greater benefits in these areas. The findings from this study will provide valuable insights into the selection of appropriate exercise regimens for elderly sedentary individuals with T2DM.

Ethics and dissemination: This study has been approved by the Ethics Review Committee of the Reproductive Hospital Affiliated with China Medical University (approval number: 202203). Informed consent will be obtained from all participants or their guardians. Upon completion, the authors will submit their findings to a peer-reviewed journal or academic conference for publication.

Clinical trial registration: Chinese Clinical Trial Registry, identifier ChiCTR2200061573.

Keywords: aging; cardiovascular health; cognitive function; high-intensity interval training; motor function; physical activity; sedentary behavior.

Grants and funding

This work was supported by the Natural Science Foundation in Jiangxi Province grant (grant nos. 202002BAB216022 to JZha, 20192ACBL21037 and 202004BCJL23049 to PY), the National Natural Science Foundation of China (grant nos. 82160371 to JZha, 82100869 to PY, and 82100347 to XL), and the Natural Science Foundation of Guangdong Province (2022A1515010582 to XL).