Comparison of interval training protocols in fully immersive virtual reality and traditional exercise on glucose levels in individuals with type 2 diabetes

Authors

  • Haritini Kourkoulou Democritus University of Thrace
  • Maria Giannousi Democritus University of Thrace
  • Charalambos Liakos Democritus University of Thrace
  • Apostolos Spassis Democritus University of Thrace
  • Nikolaos Vernadakis Democritus University of Thrace

Keywords:

virtual reality, full immersion, type 2 diabetes, interval training

Abstract

The present study aimed to compare the effects of different interval training protocols conducted in a fully immersive virtual reality environment and in a traditional exercise setting, with regard to blood glucose levels in individuals with type 2 diabetes. One protocol was implemented in a virtual reality environment, while the other took place in a conventional exercise setting. Ten individuals with diabetes (n=10), aged 43–74 years (6 men, 4 women), participated in the study and completed both training programs. Each program included a 31-minute moderate-intensity interval training session consisting of a 3-minute warm-up, two 10-minute exercise cycles with a 5-minute break in between, and a 3-minute cool-down. Blood glucose was measured before and after each session following the intake of 13.3 grams of carbohydrates in the form of a snack, using the ABBOTT Freestyle Precision Neo device. For statistical analysis, a two-way repeated measures ANOVA was used. The results showed no significant difference in glucose levels between the two protocols. In conclusion, the choice of training environment did not significantly affect glucose levels in individuals with type 2 diabetes, suggesting that the impact of the different training settings was similar.

References

Alvarez, C., Ramirez-Campillo, R., Martinez-Salazar, C., Mancilla, R., Flores-Opazo, M., Cano-Montoya, J., & Ciolac, E. G. (2016). Low-volume high-intensity interval training as a therapy for type 2 diabetes. International journal of sports medicine, 37(09), 723-729.

Anderson-Hanley, C., Snyder, A. L., Nimon, J. P., & Arciero, P. J. (2018). Social facilitation in virtual reality-enhanced exercise: Competitiveness moderates exercise effort of older adults. Clinical Interventions in Aging, 13, 1781–1790. https://doi.org/10.2147/CIA.S180317

Bird, S., & Hawley, J. (2017). Update on the effects of physical activity on insulin sensitivity in humans. BMJ Open Sport — Exercise Medicine, 2. https://doi.org/10.1136/bmjsem-2016-000143.

Bommer, C., Heesemann, E., Sagalova, V., Manne-Goehler, J., Atun, R., Bärnighausen, T., & Vollmer, S. (2018). The global economic burden of diabetes in adults aged 20–79 years: A cost-of-illness study. The Lancet Diabetes & Endocrinology, 5(6), 423-430. https://doi.org/10.1016/S2213-8587(17)30097-9

Cadmus-Bertram, L. A. (2016). Using fitness trackers in clinical research: What nurse practitioners need to know. The Journal for Nurse Practitioners, 12(1), 54-62. https://doi.org/10.1016/j.nurpra.2015.09.014

Canto, E., Ceriello, A., Rydén, L., Ferrini, M., Hansen, T., Schnell, O., Standl, E., & Beulens, J. (2019). Diabetes as a cardiovascular risk factor: An overview of global trends of macro and micro vascular complications. European Journal of Preventive Cardiology, 26, 25 - 32. https://doi.org/10.1177/2047487319878371.

Colberg, S. R., Sigal, R. J., Fernhall, B., Regensteiner, J. G., Blissmer, B. J., Rubin, R. R., Chasan-Taber, L., Albright, A. L., Braun, B., American College of Sports Medicine, & American Diabetes Association (2010). Exercise and type 2 diabetes: the American College of Sports Medicine and the American Diabetes Association: joint position statement. Diabetes care, 33(12), e147–e167. https://doi.org/10.2337/dc10-9990

Coons, M. J., Roehrig, M., & Spring, B. (2011). The potential of virtual reality technologies to improve adherence to weight loss behaviors. Journal of diabetes science and technology, 5(2), 340–344. https://doi.org/10.1177/193229681100500221

Francois, M., & Little, J. (2015). Effectiveness and Safety of High-Intensity Interval Training in Patients With Type 2 Diabetes. Diabetes Spectrum: A Publication of the American Diabetes Association, 28, 39 - 44. https://doi.org/10.2337/diaspect.28.1.39

Fu, Y., Hu, Y., & Sundstedt, V. (2022). A systematic literature review of virtual, augmented, and mixed reality game applications in healthcare. ACM Transactions on Computing for Healthcare (HEALTH), 3(2), 1-27.

Gruber, N., Shemesh-Iron, M., Kraft, E., Mitelberg, K., Mauda, E., Ben-Ami, M., Mazor-Aronovitch, K., Levy-Shraga, Y., Levran, N., Levek, N., Zimlichman, E., & Pinhas-Hamiel, O. (2024). Virtual reality's impact on children with type 1 diabetes: a proof-of-concept randomized cross-over trial on anxiety, pain, adherence, and glycemic control. Acta diabetologica, 61(2), 215–224. https://doi.org/10.1007/s00592-023-02195-9

Hu, F. B. (2011). Globalization of diabetes: The role of diet, lifestyle, and genes. Diabetes Care, 34(6), 1249-1257. https://doi.org/10.2337/dc11-0442

Kerr, D., Axelrod, C., Hoppe, C., & Klonoff, D. C. (2018). Diabetes and technology in 2030: a utopian or dystopian future? Diabetic medicine: a journal of the British Diabetic Association, 35(4), 498–503. https://doi.org/10.1111/dme.13586

Korkiakangas, E., Alahuhta, M., & Laitinen, J. (2009). Barriers to regular exercise among adults at high risk or diagnosed with type 2 diabetes: a systematic review. Health promotion international, 24(4), 416-27. https://doi.org/10.1093/heapro/dap031

Lee, Y. J., Hong, J. H., Hur, M. H., & Seo, E. Y. (2023). Effects of Virtual Reality Exercise Program on Blood Glucose, Body Composition, and Exercise Immersion in Patients with Type 2 Diabetes. International journal of environmental research and public health, 20(5), 4178. https://doi.org/10.3390/ijerph20054178

Little, J., Gillen, J., Percival, M., Safdar, A., Tarnopolsky, M., Punthakee, Z., Jung, M., & Gibala, M. (2011). Low-volume high-intensity interval training reduces hyperglycemia and increases muscle mitochondrial capacity in patients with type 2 diabetes. Journal of applied physiology, 111(6), 1554-60. https://doi.org/10.1152/japplphysiol.00921.2011

Mendes, R., Sousa, N., Themudo-Barata, J., & Reis, V. (2019). High-Intensity Interval Training Versus Moderate-Intensity Continuous Training in Middle-Aged and Older Patients with Type 2 Diabetes: A Randomized Controlled Crossover Trial of the Acute Effects of Treadmill Walking on Glycemic Control. International Journal of Environmental Research and Public Health, 16. https://doi.org/10.3390/ijerph16214163

Rollo, M. E., Aguiar, E. J., Williams, R. L., Wynne, K., Kriss, M., Callister, R., & Collins, C. E. (2016). eHealth technologies to support nutrition and physical activity behaviors in diabetes self-management. Diabetes, metabolic syndrome and obesity: targets and therapy, 9, 381–390. https://doi.org/10.2147/DMSO.S95247

Mouatt, B., Smith, A., Mellow, M., Parfitt, G., Smith, R., & Stanton, T. (2020). The Use of Virtual Reality to Influence Motivation, Affect, Enjoyment, and Engagement During Exercise: A Scoping Review. Frontiers in Virtual Reality. 1.10.3389/frvir.2020.564664.

Neira-Tovar, L., & Castilla Rodriguez, I. (2017). A virtual reality tool applied to improve the effects on chronic diseases-case: Emotional effects on T2DM. In Virtual, Augmented and Mixed Reality: 9th International Conference, VAMR 2017, Held as Part of HCI International 2017, Vancouver, BC, Canada, July 9-14, 2017, Proceedings 9. (pp. 417-425). Springer International Publishing

Neira-Tovar, L., & Elizondo Elizondo, M. E. (2018). A virtual reality serious game to prevent type 2 diabetes mellitus. In Smart Technology: First International Conference, MTYMEX 2017, Monterrey, Mexico, May 24-26, 2017, Proceedings (pp. 178-188). Springer International Publishing.

Saeedi, P., Petersohn, I., Salpea, P., Malanda, B., Karuranga, S., Unwin, N., Colagiuri, S., Guariguata, L., Motala, A. A., Ogurtsova, K., Shaw, J. E., Bright, D., & Williams, R. (2019). Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Research and Clinical Practice, 157, 107843. https://doi.org/10.1016/j.diabres.2019.107843

Schellenberg, E. S., Dryden, D. M., Vandermeer, B., Ha, C., & Korownyk, C. (2021). Lifestyle interventions for patients with and at risk for type 2 diabetes: A systematic review and meta-analysis. Annals of Internal Medicine, 159(8), 543-551. https://doi.org/10.7326/0003-4819-159-8-201310150-00007

Sugandh, F., Chandio, M., Raveena, F., Kumar, L., Karishma, F., Khuwaja, S., Memon, U. A., Bai, K., Kashif, M., Varrassi, G., Khatri, M., & Kumar, S. (2023). Advances in the Management of Diabetes Mellitus: A Focus on Personalized Medicine. Cureus, 15(8), e43697. https://doi.org/10.7759/cureus.43697

Vaughan N. (2024). Virtual Reality Meets Diabetes. Journal of diabetes science and technology, 19322968231222022. Advance online publication. https://doi.org/10.1177/19322968231222022

Vogt, T., Herpers, R., Askew, C., Scherfgen, D., Strüder, H., & Schneider, S. (2015). Effects of Exercise in Immersive Virtual Environments on Cortical Neural Oscillations and Mental State. Neural Plasticity, 2015. https://doi.org/10.1155/2015/523250.

Yanai, H., Adachi, H., Masui, Y., Katsuyama, H., Kawaguchi, A., Hakoshima, M., Waragai, Y., Harigae, T., Hamasaki, H., & Sako, A. (2018). Exercise Therapy for Patients With Type 2 Diabetes: A Narrative Review. Journal of clinical medicine research, 10(5), 365-369. https://doi.org/10.14740/jocmr3382w

Zimmet, P., Alberti, K., & Shaw, J. (2001). Global and societal implications of the diabetes epidemic. Nature, 414, 782-787. https://doi.org/10.1038/414782a.

Published

2025-06-26

How to Cite

Κούρκουλου Χ., Γιαννούση Μ., Λιάκος Χ., Σπάσης Α., & Βερναδάκης Ν. (2025). Comparison of interval training protocols in fully immersive virtual reality and traditional exercise on glucose levels in individuals with type 2 diabetes. Exercise and Society, 2, 25–38. Retrieved from https://ojs.staff.duth.gr/index.php/ExSoc/article/view/544

Issue

Section

Education, Didactic and Sports Phsychology