BACKGROUND: This study aimed to compare the acute effects of high-intensity interval training (HIIT) versus moderate-intensity continuous training (MICT) on glycemic control in middle-aged and older patients with type 2 diabetes (T2D), using treadmill walking as aerobic exercise mode. METHODS: Fifteen patients with T2D (60.25 +/- 3.14 years; glycated hemoglobin 7.03 +/- 0.33%; medicated with metformin and/or gliptins), participated in a randomized controlled crossover trial. They underwent three experimental conditions (treadmill walking HIIT session (5 x (3 min at 70% of heart rate reserve (HRR) plus 3 min at 30% HRR)); treadmill walking MICT session (30 min at 50% HRR); and a control session of rest (CON)) in random order and in the postprandial state. Measurements of capillary blood glucose (BG) were taken immediately before, during, and until 50 min after the experimental conditions. RESULTS: Both HIIT and MICT treadmill walking sessions reduced BG levels during exercise and laboratory 50 min recovery period compared to CON (time x condition interaction effect; p < 0.001). The effect of HIIT was greater compared with MICT (p = 0.017). CONCLUSIONS: Treadmill walking HIIT seems a safe and more effective exercise strategy on immediate acute glycemic control compared with MICT in middle-aged and older patients with T2D under therapy with metformin and/or gliptins. TRIAL REGISTRATION NUMBER: ISRCTN09240628.

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