Improvements in glycemic control following acute exercise are typically attributed to improved postexercise insulin sensitivity (IS) with comparatively little known about how acute exercise impacts beta cell function, especially in postmenopausal females. We determined how two high-intensity interval training (HIIT) protocols, matched for total estimated energy expenditure, impact beta cell function in postmenopausal females with type 2 diabetes. Thirteen postmenopausal females (70 +/- 5 yr; 12 +/- 7 yr since diagnosis, 80.9 +/- 13.8 kg, 32.4 +/- 5.6 kg m 2; HbA1c -49.8 +/- 10.3 mmol/mol (6.7 +/- 1.0)) living with type 2 diabetes were included in this semirandomized crossover trial. The trial involved an initial resting control condition followed by two HIIT conditions (4 x 4-min HIIT (HIIT4) and 10 x 1-min HIIT (HIIT10)) completed in a randomized order 2 to 4 days apart. beta cell function (glucose sensitivity) and insulin sensitivity were determined from a 2-h mixed-meal tolerance test performed 2 h after rest or HIIT. Both HIIT4 and HIIT10 significantly improved beta cell glucose sensitivity compared with control (15 pmol/min/m 2 / (mmol/L), (95% confidence interval (CI) 6 to 23); p = 0.002 and 16 pmol/min/m 2 / (mmol/L), (95% CI 7 to 25); p = 0.002, respectively), with no difference between HIIT protocols (1 (-8 to 10), p = 0.79). There were no significant differences in IS metrics (Matsuda index, OGIS, Stumvoli, and QUICKI) between the conditions. An acute bout of 4 x 4-min or 10 x 1-min HIIT improves beta cell glucose sensitivity in postmenopausal females living with type 2 diabetes. ClinicalTrials.gov: NCT04986345.

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