Type 1 Diabetes Mellitus is a chronic autoimmune disease caused by the body’s immune response against the β-cells of the islets of Langerhans of the pancreas, leading to their partial or total destruction. This destruction results in the inability to produce insulin and, by extension, the inability to regulate blood glucose. The treatment of T1DM consists of components, the most important of which is the administration of insulin, followed by a balanced diet and exercise.
There is great value in determining the effect of exercise in people with T1DM. A large meta-analysis focused on clarifying and quantifying this effect1.
The pooled result that came to light confirmed that exercise improves some indicators of type 1 diabetes severity.
In adults the beneficial effects appear to be notable in terms of:
- better control of body mass,
- decrease in BMI (body mass index),
- improve VO2 Max
- reduction of LDL cholesterol
For children, exercise helps:
- In the better and easier regulation of the daily dose of insulin at lower levels,
- Reduction in waist circumference,
- Reduction in LDL and triglycerides
These were the statistically significant and most impressive effects of exercise in people with T1D, but they were not the only ones as it was shown by analysis of the data that exercise also reduced resting systolic blood pressure and resting heart rate.
No effect was seen on HbA1C% (glycosylated hemoglobin) and fasting blood glucose and HDL.
In conclusion, exercise improves some indicators of type 1 diabetes severity and is rightly described in existing guidelines. These findings could be a tool in the development of new therapeutic regimens. A practical application would be to prescribe exercise in addition to medication.
However, through the reconstruction of the research data, a certain answer was not given to the question whether the exercise at the level of intensity and for the duration it brought superior.
Individual analyzes produced conflicting results in relation to weekly exercise time. Paradoxically, the longer the exercise time, the better the effect on glycemic control, yet the shorter the exercise time, the better the effect on lipids.
Exercise guidelines for type 2 diabetes were among the first to offer a sliding scale of exercise prescription, based on manipulating intensity and weekly duration to keep work volume relatively constant. These guidelines recommend 270 minutes of moderate-intensity exercise per week but only 90 minutes of vigorous activity2.
For T1DM a variable response to weekly exercise training was observed, so the existence of a two-level exercise prescription could either be related to the total work produced or to the energy consumed by the individual. Energy expenditure is the product of duration, intensity and frequency of exercise.
Future extensive research needs to be done in this area to further refine the exercise guidelines and implement them in the optimal and safest way in people with type 1 DM.
- Ostman C, Jewiss D, King N, Smart NA. Clinical outcomes to exercise training in type 1 diabetes: A systematic review and meta-analysis. Diabetes Res Clin Pract. 2018 May;139:380-391. doi: 10.1016/j.diabres.2017.11.036. Epub 2017 Dec 6. PMID: 29223408.
- ] Hordern, M. D., Coombes, J. S., Cooney, L. M., Jeffriess, L., Prins, J. B. and Marwick, T. H. Effects of exercise intervention on myocardial function in type 2 diabetes. Heart, 95, 16 (Aug 2009), 1343-1349.
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