Exercise for type 1 diabetes mellitus management: General considerations and new directions

Type 1 diabetes mellitus (T1DM) is characterized by the loss of insulin secreting cells due to a directed autoimmune process, which is linked to oxidative stress and inflammation. Exercise training is known to induce several benefits by reducing inflammation and improving antioxidant defenses. In th...

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Published inMedical hypotheses Vol. 104; pp. 147 - 153
Main Authors Farinha, Juliano Boufleur, Krause, Maurício, Rodrigues-Krause, Josianne, Reischak-Oliveira, Alvaro
Format Journal Article
LanguageEnglish
Published United States Elsevier Ltd 01.07.2017
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Online AccessGet full text
ISSN0306-9877
1532-2777
1532-2777
DOI10.1016/j.mehy.2017.05.033

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Abstract Type 1 diabetes mellitus (T1DM) is characterized by the loss of insulin secreting cells due to a directed autoimmune process, which is linked to oxidative stress and inflammation. Exercise training is known to induce several benefits by reducing inflammation and improving antioxidant defenses. In this context, exercise training may be considered as an efficient and relatively inexpensive non-pharmacological tool for diabetes treatment, added to the usual insulin administration. Unfortunately, most people with T1DM do not reach the recommended levels of physical activity due to concerns with hypoglycemic episodes. Recent data have demonstrated that exercise sessions composed by strength exercises or high-intensity interval exercise reduce the risk of hypoglycemia during and after the physical effort, when compared with continuous aerobic exercise in insulin-dependent patients. However, no studies have tested the chronic effects of this combination of protocols on health-related markers yet. Herein, we suggest a combination of hypertrophic strength exercises (3 sets at 8-RM) with a high-intensity interval protocol (10×60-s bouts at ∼90% HRmax interspersed with 60s recovery) in the same exercise session, three times per week, for T1DM patients free of micro and macrovascular complications. Our hypothesis is that this training protocol may minimize the exercise-associated rapid drop of glucose levels in T1DM, due to glucoregulatory hormones and transient reduction of insulin-mediated glucose uptake. This training is also likely to cover long-term glycaemic, bioenergetic, neuromuscular and cardiorespiratory adaptations, implicating in improved health and decreased risk of micro and macro complications.
AbstractList Abstract Type 1 diabetes mellitus (T1DM) is characterized by the loss of insulin secreting cells due to a directed autoimmune process, which is linked to oxidative stress and inflammation. Exercise training is known to induce several benefits by reducing inflammation and improving antioxidant defenses. In this context, exercise training may be considered as an efficient and relatively inexpensive non-pharmacological tool for diabetes treatment, added to the usual insulin administration. Unfortunately, most people with T1DM do not reach the recommended levels of physical activity due to concerns with hypoglycemic episodes. Recent data have demonstrated that exercise sessions composed by strength exercises or high-intensity interval exercise reduce the risk of hypoglycemia during and after the physical effort, when compared with continuous aerobic exercise in insulin-dependent patients. However, no studies have tested the chronic effects of this combination of protocols on health-related markers yet. Herein, we suggest a combination of hypertrophic strength exercises (3 sets at 8-RM) with a high-intensity interval protocol (10 x 60-s bouts at ∼90% HRmax interspersed with 60 s recovery) in the same exercise session, three times per week, for T1DM patients free of micro and macrovascular complications. Our hypothesis is that this training protocol may minimize the exercise-associated rapid drop of glucose levels in T1DM, due to glucoregulatory hormones and transient reduction of insulin-mediated glucose uptake. This training is also likely to cover long-term glycaemic, bioenergetic, neuromuscular and cardiorespiratory adaptations, implicating in improved health and decreased risk of micro and macro complications.
Type 1 diabetes mellitus (T1DM) is characterized by the loss of insulin secreting cells due to a directed autoimmune process, which is linked to oxidative stress and inflammation. Exercise training is known to induce several benefits by reducing inflammation and improving antioxidant defenses. In this context, exercise training may be considered as an efficient and relatively inexpensive non-pharmacological tool for diabetes treatment, added to the usual insulin administration. Unfortunately, most people with T1DM do not reach the recommended levels of physical activity due to concerns with hypoglycemic episodes. Recent data have demonstrated that exercise sessions composed by strength exercises or high-intensity interval exercise reduce the risk of hypoglycemia during and after the physical effort, when compared with continuous aerobic exercise in insulin-dependent patients. However, no studies have tested the chronic effects of this combination of protocols on health-related markers yet. Herein, we suggest a combination of hypertrophic strength exercises (3 sets at 8-RM) with a high-intensity interval protocol (10×60-s bouts at ∼90% HR interspersed with 60s recovery) in the same exercise session, three times per week, for T1DM patients free of micro and macrovascular complications. Our hypothesis is that this training protocol may minimize the exercise-associated rapid drop of glucose levels in T1DM, due to glucoregulatory hormones and transient reduction of insulin-mediated glucose uptake. This training is also likely to cover long-term glycaemic, bioenergetic, neuromuscular and cardiorespiratory adaptations, implicating in improved health and decreased risk of micro and macro complications.
Type 1 diabetes mellitus (T1DM) is characterized by the loss of insulin secreting cells due to a directed autoimmune process, which is linked to oxidative stress and inflammation. Exercise training is known to induce several benefits by reducing inflammation and improving antioxidant defenses. In this context, exercise training may be considered as an efficient and relatively inexpensive non-pharmacological tool for diabetes treatment, added to the usual insulin administration. Unfortunately, most people with T1DM do not reach the recommended levels of physical activity due to concerns with hypoglycemic episodes. Recent data have demonstrated that exercise sessions composed by strength exercises or high-intensity interval exercise reduce the risk of hypoglycemia during and after the physical effort, when compared with continuous aerobic exercise in insulin-dependent patients. However, no studies have tested the chronic effects of this combination of protocols on health-related markers yet. Herein, we suggest a combination of hypertrophic strength exercises (3 sets at 8-RM) with a high-intensity interval protocol (10×60-s bouts at ∼90% HRmax interspersed with 60s recovery) in the same exercise session, three times per week, for T1DM patients free of micro and macrovascular complications. Our hypothesis is that this training protocol may minimize the exercise-associated rapid drop of glucose levels in T1DM, due to glucoregulatory hormones and transient reduction of insulin-mediated glucose uptake. This training is also likely to cover long-term glycaemic, bioenergetic, neuromuscular and cardiorespiratory adaptations, implicating in improved health and decreased risk of micro and macro complications.
Type 1 diabetes mellitus (T1DM) is characterized by the loss of insulin secreting cells due to a directed autoimmune process, which is linked to oxidative stress and inflammation. Exercise training is known to induce several benefits by reducing inflammation and improving antioxidant defenses. In this context, exercise training may be considered as an efficient and relatively inexpensive non-pharmacological tool for diabetes treatment, added to the usual insulin administration. Unfortunately, most people with T1DM do not reach the recommended levels of physical activity due to concerns with hypoglycemic episodes. Recent data have demonstrated that exercise sessions composed by strength exercises or high-intensity interval exercise reduce the risk of hypoglycemia during and after the physical effort, when compared with continuous aerobic exercise in insulin-dependent patients. However, no studies have tested the chronic effects of this combination of protocols on health-related markers yet. Herein, we suggest a combination of hypertrophic strength exercises (3 sets at 8-RM) with a high-intensity interval protocol (10×60-s bouts at ∼90% HRmax interspersed with 60s recovery) in the same exercise session, three times per week, for T1DM patients free of micro and macrovascular complications. Our hypothesis is that this training protocol may minimize the exercise-associated rapid drop of glucose levels in T1DM, due to glucoregulatory hormones and transient reduction of insulin-mediated glucose uptake. This training is also likely to cover long-term glycaemic, bioenergetic, neuromuscular and cardiorespiratory adaptations, implicating in improved health and decreased risk of micro and macro complications.Type 1 diabetes mellitus (T1DM) is characterized by the loss of insulin secreting cells due to a directed autoimmune process, which is linked to oxidative stress and inflammation. Exercise training is known to induce several benefits by reducing inflammation and improving antioxidant defenses. In this context, exercise training may be considered as an efficient and relatively inexpensive non-pharmacological tool for diabetes treatment, added to the usual insulin administration. Unfortunately, most people with T1DM do not reach the recommended levels of physical activity due to concerns with hypoglycemic episodes. Recent data have demonstrated that exercise sessions composed by strength exercises or high-intensity interval exercise reduce the risk of hypoglycemia during and after the physical effort, when compared with continuous aerobic exercise in insulin-dependent patients. However, no studies have tested the chronic effects of this combination of protocols on health-related markers yet. Herein, we suggest a combination of hypertrophic strength exercises (3 sets at 8-RM) with a high-intensity interval protocol (10×60-s bouts at ∼90% HRmax interspersed with 60s recovery) in the same exercise session, three times per week, for T1DM patients free of micro and macrovascular complications. Our hypothesis is that this training protocol may minimize the exercise-associated rapid drop of glucose levels in T1DM, due to glucoregulatory hormones and transient reduction of insulin-mediated glucose uptake. This training is also likely to cover long-term glycaemic, bioenergetic, neuromuscular and cardiorespiratory adaptations, implicating in improved health and decreased risk of micro and macro complications.
Author Rodrigues-Krause, Josianne
Reischak-Oliveira, Alvaro
Krause, Maurício
Farinha, Juliano Boufleur
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  surname: Reischak-Oliveira
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Snippet Type 1 diabetes mellitus (T1DM) is characterized by the loss of insulin secreting cells due to a directed autoimmune process, which is linked to oxidative...
Abstract Type 1 diabetes mellitus (T1DM) is characterized by the loss of insulin secreting cells due to a directed autoimmune process, which is linked to...
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SubjectTerms Adult
Blood Glucose - analysis
Diabetes Mellitus, Type 1 - complications
Diabetes Mellitus, Type 1 - therapy
Exercise Therapy
Humans
Hypoglycemia
Hypoglycemic Agents - therapeutic use
Inflammation
Insulin - therapeutic use
Internal Medicine
Microcirculation
Middle Aged
Models, Theoretical
Oxidative Stress
Oxygen Consumption
Young Adult
Title Exercise for type 1 diabetes mellitus management: General considerations and new directions
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