ATS BULLETIN - 20/03/2015


Category: Hypoxic Training & Blood Glucose Regulation  

Application: Clinical populations - Diabetes Type II


Intermittent Exercise with and without Hypoxia Improves Insulin Sensitivity in Individuals with Type 2 Diabetes

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ATS BULLETIN 2015-03-20


Category             - Hypoxic Training & Blood Glucose Regulation

Application         - Clinical populations - Diabetes Type II


Research Overview


Intermittent Exercise with and without Hypoxia Improves Insulin Sensitivity in Individuals with Type 2 Diabetes

Publish Date

January 2012


R. Mackenzie, N. Maxwell, P. Castle, G. Brickley & P. Watt


University of Westminister, London, UK

Number / Type of Participants

8 Sedentary Males with existing T2D; 58±2yrs; BMI 28.3 ± 2.1

Altitude Level

2,900m / O2 14.7%


Executive Summary

Acute exercise in simulated altitude was compared to intermittent exercise in both simulated altitude and at sea level; to examine the effects on blood glucose regulation in individuals with pre-existing Type 2 Diabetes. Results indicated that:

  • Blood glucose uptake was significantly higher during continuous cycling in hypoxic conditions; compared with both intermittent exercise trials

  • Continuous hypoxic exercise had the most pronounced effect on post-exercise measures of insulin sensitivity; suggesting this is an effective method for promoting blood glucose control


Overview of Exercise Trials


8 males with diabetes type 2 (diagnosed by a G.P. within the past 5 years) completed 3 different exercise trials in simulated altitude (hypoxia) and sea level (normoxia) each totalling 60-minutes in duration:

  1. Hypoxic continuous (60minutes ex)

  2. Hypoxic intermittent (5 mins ex: 5 mins rest)

  3. Normoxic intermittent (5 mins ex: 5 mins rest)

  • Blood glucose and insulin measurements were taken at times during each of the trial sessions at specified time periods:

    • 30 minutes prior to exercise

    • During exercise at 10 minute intervals

    • 24 and 48 hours post exercise sessions


Key Outcomes


Results of the exercise trials showed that:

  • Continuous exercise in hypoxia was found more effective than intermittent exercise either in hypoxia or normoxia for blood glucose regulation

  • Both types of hypoxic exercise led to short-term improvements in fasting plasma insulin levels, but continuous exercise resulted in longer lasting effects

  • Total energy expenditure and heart rate measures were simular across all trials; but blood oxygen sats (SaO2) were lower during continuous hypoxia than intermittent normoxia.


    • Despite the metabolic responses being similar across all 3 trials, continuous hypoxic exercise provided the greatest improvements in blood glucose regulation


Exercise Trials




Total Time

Interval Time



Cycling Exercise






Continuous Hypoxic Exercise

60 min



90% LT



14.8 ± 0.4% Inspired O2






Intermittent Hypoxic Exercise

5:5 work-to-rest



120% LT




14.8 ± 0.4% Inspired O2






Intermittent Normoxic Exercise

5:5 work-to-rest



120% LT




20.93% Inspired O2





*LT: Lactate Threshold. Training intensities were set based on results of preliminary testing