Comparative Efficacy of High-Intensity Interval Training, Moderate-Intensity Continuous Training, and Routine Pharmacological Treatment on Glucolipid Metabolism in Patients With Type 2 Diabetes: A Meta-Analysis

High-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) are widely used strategies for managing type 2 diabetes mellitus (T2DM), but evidence on their comparative effects and practical feasibility is limited. A systematic search of CNKI, Wanfang, PubMed, Web of Science, and EBSCO-SPORTDiscus was conducted up to January 31, 2026, to identify randomized controlled trials enrolling adults with T2DM. Twenty studies (n = 981; 49.6% male; mean age 58.04 ± 10.08 years; mean body mass index 28.03 ± 4.43 kg/m 2 ) with interventions lasting ≥8 weeks reporting fasting blood glucose (FBG), fasting insulin (FINS), homeostatic model assessment of insulin resistance (HOMA-IR), glycated hemoglobin (HbA1c), high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides (TG), or total cholesterol (TC) were included. Data were extracted using standardized spreadsheets. Statistical analysis included standardized mean differences (SMDs) with 95% confidence intervals, heterogeneity assessment, and Egger’s test for publication bias. Compared with routine pharmacological treatment, HIIT significantly improved FBG (SMD = −1.24), HbA1c (–1.40), HOMA-IR (–1.03), FINS (–0.97), HDL (0.86), and TG (–0.55) (all P < .05), while no significant differences were observed for LDL, TC, or between HIIT and MICT. A 12-week, thrice-weekly HIIT protocol was most effective for glycemic control. High-intensity interval training’s time efficiency and motivational appeal may enhance adherence and support implementation in clinical practice and public health programs.