1. Jia G, Hill MA, Sowers JR. Diabetic cardiomyopathy: An update of mechanisms contributing to this clinical entity. Circ Res. 2018;122(4):624–38. https://doi.org/10.1161/circresaha.117.311586
2. Del Re DP, Amgalan D, Linkermann A, Liu Q, Kitsis RN. Fundamental mechanisms of regulated cell death and implications for heart disease. Physiological Reviews. 2019;99(4):1765–817. https://doi.org/10.1152/physrev.00022.2018
3. Dillmann WH. Diabetic cardiomyopathy: What is it and can it be fixed? Circulation Research. 2019;124(8):1160–2. https://doi.org/10.1161/CIRCRESAHA.118.31466
4. Wei J, Zhao Y, Liang H, Du W, Wang L. Preliminary evidence for the presence of multiple forms of cell death in diabetes cardiomyopathy. Acta Pharmaceutica Sinica B. 2022;12(1):1–17. https://doi.org/10.1016/j.apsb.2021.08.026
5. Kazemi Nesab F, Zafarmand O. Comparison of the effects of high-intensity intermittent training and moderate-intensity continuous training on cardiometabolic factors in type 2 diabetic patients: a systematic review and meta-analysis. Feyz Medical Sciences Journal. 2024;28(1):96–109 https://doi.org/10.48307/FMSJ.2024.28.1.98
6. Aydin S, Ugur K, Aydin S, Sahin İ, Yardim M. Biomarkers in acute myocardial infarction: current perspectives. Vascular health and Risk Management. 2019:1–10. https://doi.org/10.2147/VHRM.S166157
7. Marston SB. How do mutations in contractile proteins cause the primary familial cardiomyopathies? Journal of Cardiovascular Translational Research. 2011;4(3):245–55. https://link.springer.com/article/10.1007/s12265-011-9266-2
8. Li N, Zhou T, Fei E. Actions of metformin in the brain: a new perspective of metformin treatments in related neurological disorders. International Journal of Molecular Sciences. 2022;23(15):8281. https://doi.org/10.3390/ijms23158281
9. Dutta S, Shah RB, Singhal S, Dutta SB, Bansal S, Sinha S, et al. Metformin: a review of potential mechanism and therapeutic utility beyond diabetes. Drug design, Development and Therapy. 2023:1907–32. https://doi.org/10.2147/DDDT.S409373
10. Goel S, Singh R, Singh V, Singh H, Kumari P, Chopra H, et al. Metformin: Activation of 5′ AMP-activated protein kinase and its emerging potential beyond anti-hyperglycemic action. Frontiers in Genetics. 2022;13:1022739. https://doi.org/10.3389/fgene.2022.1022739
11. Riddell MC, Davis EA, Mayer-Davis EJ, Kahkoska A, Zaharieva DP. Advances in exercise and nutrition as therapy in diabetes. Diabetes Technology & Therapeutics. 2021;23(S2):S–131–S–42. https://doi.org/10.1089/dia.2021.2509
12. King AC, Powell KE, Kraus WE. The US physical activity guidelines advisory committee report-introduction. Med Sci Sports Exerc. 2019;51(6):1203–5. https://doi.org/10.1249/MSS.0000000000001946
13. Baghadam M, Mohamadzadeh salamat K, Azizbeidi K, Baesi K. THE effect of 8 weeks aerobic training on cardiac PGC-1Α and plasma irisin in stz-induced diabetics’ rats. Iranian Journal of Diabetes and Lipid Disorders. 2019;18(5):228–35.
14. Colberg SR, Sigal RJ, Yardley JE, Riddell MC, Dunstan DW, Dempsey PC, et al. Physical activity/exercise and diabetes: a position statement of the American Diabetes Association. Diabetes Care. 2016;39(11):2065. https://doi.org/10.2337/dc16-1728
15. Dong G, Ryan TE, Esser KA. Animal models of exercise and cardiometabolic disease. Circulation Research. 2025;137(2):139–62. https://doi.org/10.1161/CIRCRESAHA.124.325704
16. Kazemi A, Eslami R, Karimghasemi L. The effect of high-intensity interval training on tumor necrosis factor-alpha levels in visceral and subcutaneous adipose tissue and insulin resistance in male Rats. Sport Physiology. 2016;8(32):17–30. https://doi.org/10.22089/spj.2016.860
17. Kanter M, Aksu F, Takir M, Kostek O, Kanter B, Oymagil A. Effects of low intensity exercise against apoptosis and oxidative stress in Streptozotocin-induced diabetic rat heart. Experimental and Clinical Endocrinology & Diabetes. 2017;125(09):583–91. https://doi.org/10.1055/s-0035-1569332
18. Teixeira de Lemos E, Pinto R, Oliveira J, Garrido P, Sereno J, Mascarenhas-Melo F, et al. Differential effects of acute (extenuating) and chronic (training) exercise on inflammation and oxidative stress status in an animal model of type 2 diabetes mellitus. Mediators of Inflammation. 2011;2011(1):253061. https://doi.org/10.1155/2011/253061
19. Yazdani F, Shahidi F, Karimi P. The effect of 8 weeks of high-intensity interval training and moderate-intensity continuous training on cardiac angiogenesis factor in diabetic male rats. Journal of Physiology and Biochemistry. 2020;76(2):291–9. https://link.springer.com/article/10.1007/s13105-020-00733-5
20. Delfan M, Delphan M, Kordi MR, Ravasi AA, Safa M, Gorgani-Firuzjaee S, et al. High intensity interval training improves diabetic cardiomyopathy via miR-1 dependent suppression of cardiomyocyte apoptosis in diabetic rats. Journal of Diabetes & Metabolic Disorders. 2020;19(1):145–52. https://link.springer.com/article/10.1007/S40200-019-00485-0
21. Yang Z, Wang M, Zhang Y, Cai F, Jiang B, Zha W, et al. Metformin ameliorates diabetic cardiomyopathy by activating the PK2/PKR pathway. Frontiers in Physiology. 2020;11:425. https://doi.org/10.3389/fphys.2020.00425
22. Wang Y, Sun H, Zhang J, Xia Z, Chen W. Streptozotocin-induced diabetic cardiomyopathy in rats: ameliorative effect of PIPERINE via Bcl2, Bax/Bcl2, and caspase-3 pathways. Bioscience, Biotechnology, and Biochemistry. 2020;84(12):2533–44. https://doi.org/10.1080/09168451.2020.1815170
23. Badri Z, Delfan M, Daneshyar S. The combined effect of high-intensity interval training and metformin on gene expression of myogenin and myostatin in skeletal muscle of type 2 diabetic mice. 2022.
24. Rami M, Rahdar S, Ahmadi Hekmatikar A, Awang Daud DM. Highlighting the novel effects of high-intensity interval training on some histopathological and molecular indices in the heart of type 2 diabetic rats. Frontiers in Endocrinology. 2023;14:1175585. https://doi.org/10.3389/fendo.2023.1175585
25. Liu Q, Wang S, Cai L. Diabetic cardiomyopathy and its mechanisms: role of oxidative stress and damage. Journal of diabetes investigation. 2014;5(6):623–34. https://doi.org/10.1111/jdi.12250
26. Peng M-l, Fu Y, Wu C-w, Zhang Y, Ren H, Zhou S-s. Signaling pathways related to oxidative stress in diabetic cardiomyopathy. Frontiers in Endocrinology. 2022;13:907757. https://doi.org/10.3389/fendo.2022.907757
27. De Geest B, Mishra M. Role of oxidative stress in diabetic cardiomyopathy. Antioxidants. 2022;11(4):784. https://doi.org/10.3390/antiox11040784
28. Sabahi Z, Khoshnoud MJ, Hosseini S, Khoshraftar F, Rashedinia M. Syringic acid attenuates cardiomyopathy in streptozotocin‐induced diabetic rats. Advances in Pharmacological and Pharmaceutical Sciences. 2021;2021(1):5018092. https://doi.org/10.1155/2021/5018092
29. Yang F, Qin Y, Wang Y, Meng S, Xian H, Che H, et al. Metformin inhibits the NLRP3 inflammasome via AMPK/mTOR-dependent effects in diabetic cardiomyopathy. International Journal of Biological Sciences. 2019;15(5):1010. https://doi.org/10.7150/ijbs.29680
30. Xu N, Liu S, Zhang Y, Chen Y, Zuo Y, Tan X, et al. Oxidative stress signaling in the pathogenesis of diabetic cardiomyopathy and the potential therapeutic role of antioxidant naringenin. Redox Report. 2023;28(1):2246720. https://doi.org/10.1080/13510002.2023.2246720
31. D’Haese S, Verboven M, Evens L, Deluyker D, Lambrichts I, Eijnde B, et al. Moderate-and high-intensity endurance training alleviate diabetes-induced cardiac dysfunction in rats. Nutrients. 2023;15(18):3950. https://doi.org/10.3390/nu15183950
32. Patel SS, Goyal RK. Prevention of diabetes-induced myocardial dysfunction in rats using the juice of the Emblica officinalis fruit. Experimental & Clinical Cardiology. 2011;16(3):87.
33. Chen H, Guo L. Exercise in Diabetic Cardiomyopathy: Its Protective Effects and Molecular Mechanism. International Journal of Molecular Sciences. 2025;26(4):1465. https://doi.org/10.3390/ijms26041465
34. Cassidy S, Thoma C, Houghton D, Trenell MI. High-intensity interval training: a review of its impact on glucose control and cardiometabolic health. Diabetologia. 2017;60(1):7–23. https://link.springer.com/article/10.1007/s00125-016-4106-1
35. MH Eijsvogels T, Shave R, van Dijk A, TE Hopman M, HJ Thijssen D. Exercise-induced cardiac troponin release: real-life clinical confusion. Current Medicinal Chemistry. 2011;18(23):3457–61. https://doi.org/10.2174/092986711796642526
36. Dziubak A, Wójcicka G, Wojtak A, Bełtowski J. Metabolic effects of metformin in the failing heart. International Journal of Molecular Sciences. 2018;19(10):2869. https://doi.org/10.3390/ijms19102869
37. Salman IM, Inamdar MN. Effect of gliclazide on cardiovascular risk factors involved in split-dose streptozotocin induced neonatal rat model: a chronic study. 2012.
38. Shabab S, Mahmoudabady M, Gholamnezhad Z, Niazmand S, Fouladi M, Emadi ZM. Endurance exercise prevented diabetic cardiomyopathy through the inhibition of fibrosis and hypertrophy in rats. Reviews in Cardiovascular Medicine. 2024;25(5):173. https://doi.org/10.31083/j.rcm2505173
39. Harada N. Effects of metformin on blood glucose levels and bodyweight mediated through intestinal effects. Journal of Diabetes Investigation. 2020;11(6):1420. https://doi.org/1010.1111/jdi.13301
40. Kułaczkowska ZM, Wróbel M, Rokicka D, Gąsior M, Strojek K. Metformin in patients with type 2 diabetes mellitus and heart failure: a review. Endokrynologia Polska. 2021;72(2):163–70. https://doi.org/1010.5603/EP.a2021.0033
41. Azimidokht SMA, Mogharnasi M, Kargar Shouroki MK, Zarezade Mehrizi AA. The effect of 8 weeks interval training on insulin resistance and lipid profiles in type 2 diabetic men treated with metformin. Journal of Sport Biosciences. 2015;7(3):461–76. https://doi.org/10.22059/jsb.2015.56260
42. Rangraz TM, Nikbakht M, Ranjbar R, Daryanoosh F, Ghanbarzadeh M. Effect of eight weeks high intensity interval training (HIIT) on asprosin, lipid profile and insulin resistance in type 2 diabetic male rats. 2023.
43. Ghalavand A, Delaramnasab M, Afshounpour M, Zare A. Effects of continuous aerobic exercise and circuit resistance training on fasting blood glucose control and plasma lipid profile in male patients with type II diabetes mellitus. Journal of Diabetes Nursing. 2016;4(1):8–19.
44. Shahidi F, Kashef M, Namdari M. The effect of a period of low-volume and high-intensity aerobic interval training on the response of structural and functional indicators of the heart in patients with myocardial infarction. 2023.
45. Rostami N, Afroundeh R, Seifi-skishahr F. Effect of Moderate Intensity Interval Training on the Expression of Genes Related to Necroptosis of Heart Tissue in Male Heart Attack Model Rats. Journal of Shahid Sadoughi University of Medical Sciences. 2024. https://doi.org/10.18502/ssu.v32i8.16857
46. Rami M, Rahdar S, Azimpour M, Khoramipour K. The effect of high intensity interval training on FOXO3, PI3K and AKT proteins content in heart muscle of type two diabetic rats. Journal of Practical Studies of Biosciences in Sport. 2023;11(27):8–21. https://doi.org/10.22077/jpsbs.2022.5485.1733
47. Malin SK, Braun B. Impact of metformin on exercise-induced metabolic adaptations to lower type 2 diabetes risk. Exercise and Sport Sciences Reviews. 2016;44(1):4–11. https://doi.org/10.1249/jes.0000000000000070
48. Boulé NG, Kenny GP, Larose J, Khandwala F, Kuzik N, Sigal RJ. Does metformin modify the effect on glycaemic control of aerobic exercise, resistance exercise or both? Diabetologia. 2013;56(11):2378–82. https://doi.org/1010.1007/s00125-013-3026-6
49. Ashcroft SP, Stocks B, Egan B, Zierath JR. Exercise induces tissue-specific adaptations to enhance cardiometabolic health. Cell Metabolism. 2024;36(2):278–300. https://doi.org/10.1016/j.cmet.2023.12.008
50. Kulkarni AS, Peck BD, Walton RG, Kern PA, Mar JC, Windham ST, et al. Metformin alters skeletal muscle transcriptome adaptations to resistance training in older adults. Aging (Albany NY). 2020;12(20):19852. https://doi.org/1010.18632/aging.104096
