Feasibility of Minimal Dose High Intensity Body-weight Circuit Training in Individuals With Type 2 Diabetes: A Pilot Study

High Intensity Body-weight Circuit T2DM


  • Brian Kliszczewicz Kennesaw State University
  • Robert Buresh
  • Herman Ray




Metabolism, Exercise, intervention


Background: The use of body-weight resistance exercise and a minimal time duration requirement can be combined to form a high intensity body-weight circuit training program (HIBC), and may be a feasible and attractive option for those with Type 2 Diabetes Mellitus (T2DM). The purpose of this pilot was to evaluate the effectiveness of an minimal time commitment HIBC intervention on metabolic biomarkers, body composition, and fitness. Methods: Three females (55±4yrs) and two males (64±1yrs) with T2DM underwent assessments of glycosylated hemoglobin (HbA1c) and fasting glucose (FG), and lipids. Body composition via dual-energy x-ray absorptiometry, aerobic fitness (submaximal treadmill test), blood pressure (SBP/DBP), and resting heart rate (RHR) were assessed. Participants completed 16-weeks of HIBC. All assessments were repeated upon completion. Results: No differences were observed in the following variables; Body composition: Pre and Post changes in mean weight 2.2 ± 2.8 (p=0.31), body fat% -0.1 ± 1.1% (p=1.0), lean mass 1.2 ± 1.22 kg (p=0.13). Aerobic fitness: estimated VO2max 2.26 ± 4.5 ml/kg/min (p=0.63), SBP -6.4 ± 12.5mmhg (p=0.38), DBP -1.4 ± 3.5mmhg (p=0.50), RHR -1.8 ± 4.7bpm (p=0.50). Metabolic biomarkers: FG -14.9 ± 33.4 mg/dL (p=0.44), HDL 1.4 ± 4.2 mg/dL (p=0.63), LDL -4.0 ± 12.6 mg/dL (p=0.63), HbA1c -0.3 ± .28% (p=0.25). Conclusions: Though the main findings of this study were not statistically significant, but the physiological responses could be clinically meaningful in that improvements in metabolic profiles were similar in magnitude to both aerobic and resistance training interventions.


American Diabetes A. Economic costs of diabetes in the u.S. In 2017. Diabetes Care 41(5):917-928, 2018.

Bartoli E, Fra GP, Carnevale Schianca GP. The oral glucose tolerance test (ogtt) revisited. Eur J Intern Med 22(1):8-12, 2011.

Boule NG, Haddad E, Kenny GP, Wells GA, Sigal RJ. Effects of exercise on glycemic control and body mass in type 2 diabetes mellitus: A meta-analysis of controlled clinical trials. JAMA 286(10):1218-1227, 2001.

Bullard KM, Cowie CC, Lessem SE, Saydah SH, Menke A, Geiss LS, Orchard TJ, Rolka DB, Imperatore G. Prevalence of diagnosed diabetes in adults by diabetes type - united states, 2016. MMWR Morb Mortal Wkly Rep 67(12):359-361, 2018.

Buresh R, Hornbuckle LM, Garrett D, Garber H, Woodward A. Associations between measures of health-related physical fitness and cardiometabolic risk factors in college students. J Am Coll Health 66(8):754-766, 2018.

Castaneda C, Layne JE, Munoz-Orians L, Gordon PL, Walsmith J, Foldvari M, Roubenoff R, Tucker KL, Nelson ME. A randomized controlled trial of resistance exercise training to improve glycemic control in older adults with type 2 diabetes. Diabetes Care 25(12):2335-2341, 2002.

Chin APMJ, van Uffelen JG, Riphagen I, van Mechelen W. The functional effects of physical exercise training in frail older people : A systematic review. Sports Med 38(9):781-793, 2008.

Cho NH, Shaw JE, Karuranga S, Huang Y, da Rocha Fernandes JD, Ohlrogge AW, Malanda B. Idf diabetes atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Res Clin Pract 138:271-281, 2018.

Church TS, Blair SN, Cocreham S, Johannsen N, Johnson W, Kramer K, Mikus CR, Myers V, Nauta M, Rodarte RQ, Sparks L, Thompson A, Earnest CP. Effects of aerobic and resistance training on hemoglobin a1c levels in patients with type 2 diabetes: A randomized controlled trial. JAMA 304(20):2253-2262, 2010.

Colberg SR, Sigal RJ, Yardley JE, Riddell MC, Dunstan DW, Dempsey PC, Horton ES, Castorino K, Tate DF. Physical activity/exercise and diabetes: A position statement of the american diabetes association. Diabetes Care 39(11):2065-2079, 2016.

Fahlman MM, Topp R, McNevin N, Morgan AL, Boardley DJ. Structured exercise in older adults with limited functional ability. J Gerontol Nurs 33(6):32-39, 2007.

Fealy CE, Nieuwoudt S, Foucher JA, Scelsi AR, Malin SK, Pagadala M, Cruz LA, Li M, Rocco M, Burguera B, Kirwan JP. Functional high-intensity exercise training ameliorates insulin resistance and cardiometabolic risk factors in type 2 diabetes. Exp Physiol 103(7):985-994, 2018.

Feito Y, Heinrich KM, Butcher SJ, Poston WSC. High-intensity functional training (hift): Definition and research implications for improved fitness. Sports (Basel) 6(3)2018.

Foster C, Jackson AS, Pollock ML, Taylor MM, Hare J, Sennett SM, Rod JL, Sarwar M, Schmidt DH. Generalized equations for predicting functional capacity from treadmill performance. Am Heart J 107(6):1229-1234, 1984.

Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte MJ, Lee IM, Nieman DC, Swain DP, American College of Sports M. American college of sports medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: Guidance for prescribing exercise. Med Sci Sports Exerc 43(7):1334-1359, 2011.

Gibala MJ, Little JP, Macdonald MJ, Hawley JA. Physiological adaptations to low-volume, high-intensity interval training in health and disease. J Physiol 590(5):1077-1084, 2012.

Gillen JB, Little JP, Punthakee Z, Tarnopolsky MA, Riddell MC, Gibala MJ. Acute high-intensity interval exercise reduces the postprandial glucose response and prevalence of hyperglycaemia in patients with type 2 diabetes. Diabetes Obes Metab 14(6):575-577, 2012.

Jelleyman C, Yates T, O'Donovan G, Gray LJ, King JA, Khunti K, Davies MJ. The effects of high-intensity interval training on glucose regulation and insulin resistance: A meta-analysis. Obes Rev 16(11):942-961, 2015.

Kadoglou NP, Iliadis F, Angelopoulou N, Perrea D, Ampatzidis G, Liapis CD, Alevizos M. The anti-inflammatory effects of exercise training in patients with type 2 diabetes mellitus. Eur J Cardiovasc Prev Rehabil 14(6):837-843, 2007.

Karstoft K, Winding K, Knudsen SH, Nielsen JS, Thomsen C, Pedersen BK, Solomon TP. 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. Diabetes Care 36(2):228-236, 2013.

Kerner W, Bruckel J, German Diabetes A. Definition, classification and diagnosis of diabetes mellitus. Exp Clin Endocrinol Diabetes 122(7):384-386, 2014.

Kirwan JP, Sacks J, Nieuwoudt S. The essential role of exercise in the management of type 2 diabetes. Cleve Clin J Med 84(7 Suppl 1):S15-S21, 2017.

Korkiakangas EE, Alahuhta MA, Laitinen JH. Barriers to regular exercise among adults at high risk or diagnosed with type 2 diabetes: A systematic review. Health Promot Int 24(4):416-427, 2009.

Lidegaard LP, Schwennesen N, Willaing I, Faerch K. Barriers to and motivators for physical activity among people with type 2 diabetes: Patients' perspectives. Diabet Med 33(12):1677-1685, 2016.

Little JP, Gillen JB, Percival ME, Safdar A, Tarnopolsky MA, Punthakee Z, Jung ME, Gibala MJ. Low-volume high-intensity interval training reduces hyperglycemia and increases muscle mitochondrial capacity in patients with type 2 diabetes. J Appl Physiol (1985) 111(6):1554-1560, 2011.

Mogre V, Johnson NA, Tzelepis F, Shaw JE, Paul C. A systematic review of adherence to diabetes self-care behaviours: Evidence from low-and middle-income countries. J Adv Nurs 2019.

Navalta JW, Stone WJ, Lyons TS. Ethical issues relating to scientific discovery in exercise science. Int J Exerc Sci 12(1):1-8, 2019.

Nieuwoudt S, Fealy CE, Foucher JA, Scelsi AR, Malin SK, Pagadala M, Rocco M, Burguera B, Kirwan JP. Functional high-intensity training improves pancreatic beta-cell function in adults with type 2 diabetes. Am J Physiol Endocrinol Metab 313(3):E314-E320, 2017.

Perri MG, Anton SD, Durning PE, Ketterson TU, Sydeman SJ, Berlant NE, Kanasky WF, Jr., Newton RL, Jr., Limacher MC, Martin AD. Adherence to exercise prescriptions: Effects of prescribing moderate versus higher levels of intensity and frequency. Health Psychol 21(5):452-458, 2002.

Phillips BE, Kelly BM, Lilja M, Ponce-Gonzalez JG, Brogan RJ, Morris DL, Gustafsson T, Kraus WE, Atherton PJ, Vollaard NBJ, Rooyackers O, Timmons JA. A practical and time-efficient high-intensity interval training program modifies cardio-metabolic risk factors in adults with risk factors for type ii diabetes. Front Endocrinol (Lausanne) 8:229, 2017.

Shaban N, Kenno KA, Milne KJ. The effects of a 2 week modified high intensity interval training program on the homeostatic model of insulin resistance (homa-ir) in adults with type 2 diabetes. J Sports Med Phys Fitness 54(2):203-209, 2014.

Sigal RJ, Kenny GP, Boule NG, Wells GA, Prud'homme D, Fortier M, Reid RD, Tulloch H, Coyle D, Phillips P, Jennings A, Jaffey J. Effects of aerobic training, resistance training, or both on glycemic control in type 2 diabetes: A randomized trial. Ann Intern Med 147(6):357-369, 2007.

Snowling NJ, Hopkins WG. Effects of different modes of exercise training on glucose control and risk factors for complications in type 2 diabetic patients: A meta-analysis. Diabetes Care 29(11):2518-2527, 2006.

Spiteri K, Broom D, Bekhet AH, de Caro JX, Laventure B, Grafton K. Barriers and motivators of physical activity participation in middle-aged and older-adults - a systematic review. J Aging Phys Act:1-80, 2019.

Stoa EM, Meling S, Nyhus LK, Glenn S, Mangerud KM, Helgerud J, Bratland-Sanda S, Storen O. High-intensity aerobic interval training improves aerobic fitness and hba1c among persons diagnosed with type 2 diabetes. Eur J Appl Physiol 117(3):455-467, 2017.

Stutts WC. Physical activity determinants in adults. Perceived benefits, barriers, and self efficacy. AAOHN J 50(11):499-507, 2002.

Terada T, Friesen A, Chahal BS, Bell GJ, McCargar LJ, Boule NG. Feasibility and preliminary efficacy of high intensity interval training in type 2 diabetes. Diabetes Res Clin Pract 99(2):120-129, 2013.

Thompson WR. Worldwide survey of fitness trends for 2016 10th anniversary edition. Acsms Health Fit J 19(6):9-18, 2015.

Thompson WR. Worldwide survey of fitness trends for 2017. Acsms Health Fit J 20(6):8-17, 2016.

Thompson WR. Worldwide survey of fitness trends for 2018 the crep edition. Acsms Health Fit J 21(6):10-19, 2017.

Umpierre D, Ribeiro PA, Kramer CK, Leitao CB, Zucatti AT, Azevedo MJ, Gross JL, Ribeiro JP, Schaan BD. Physical activity advice only or structured exercise training and association with hba1c levels in type 2 diabetes: A systematic review and meta-analysis. JAMA 305(17):1790-1799, 2011.

Venkataramani M, Pollack CE, Yeh HC, Maruthur NM. Prevalence and correlates of diabetes prevention program referral and participation. Am J Prev Med 56(3):452-457, 2019.

WILCOXON F. Individual comparisons of grouped data by ranking methods. J Econ Entomol 39:269, 1946.






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