Exercise as it relates to Disease/Effects of aerobic exercise on type 1 diabetes

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Background[edit]

Type 1 Diabetes Mellitus (T1DM) is a form of diabetes mellitus that results from autoimmune destruction of insulin-producing beta cells of the pancreas. It is an inflammatory autoimmune disease of the pancreas, resulting in a lack of insulin[1]. Risk factors for developing Type 1 Diabetes [2] include:

  • Genetics[2]
  • Environmental[2]
  • Gestational Infection[2]
  • Childhood Infection[2]

The rate of diabetes in Australia has shown a steady increase from 2.4% in 1995 to 3.8% in 2007–08[3].
In 2007-08, 10% of the Australian population who suffered from diabetes (82,000 people) reported they had Type 1 diabetes, while 2% of people with diabetes did not know which type of diabetes they had[3].

Aerobic Exercise[edit]

Type 1 diabetes mellitus sufferers often tend to avoid participating in aerobic exercise due to fear of enhancing more acute symptoms relating to the disease[4][5]. Although this practice may reduce the immediate effects T1DM places on the body, it may increase the prevalence of other lifestyle complications including:

  • Increased weight gain
  • Decreased muscle mass
  • Decreased bone density
  • Decrease insulin sensitivity
  • Decreased life expectancy
  • Increased risk of lifestyle diseases


These problems can affect common everyday tasks such as making it difficult to walk up a flight of stairs. They also dramatically affect the long term health of the patient.

Benefits of Aerobic Exercise[edit]

Recent research has shown sufficient evidence to indicate that aerobic exercise does not negatively affect Type I diabetes mellitus symptoms and is completely safe for patients suffering with well-controlled diabetes mellitus [6]. Aerobic exercise has been shown to:

  • Improve glucose tolerance [6]
  • Reduce insulin requirements/increase insulin sensitivity [6]
  • Potentially lower glycosylated haemoglobin [7]
  • Reduced risk of CVD, hypertension, colon cancer, obesity and osteoporosis [7]
  • Increased overall life expectancy [7]
  • Increased CV endurance, muscle fitness and flexibility [7]


Aerobic exercise also contributes to psychological health benefits [7] which may include:

  • Improved self-esteem [7]
  • Enhanced sense of well-being [7]
  • Improved social interaction skills


Recommendations- Aerobic Exercise[edit]

In order to gain the maximum benefits from aerobic exercise, the following recommendations should be followed:

  • 5 sessions/week [5]
  • 60-90% MHR [5] depending on individual
  • 30-90 mins [5]
  • Each training program may need to be personalised with GP recommendations and a pre-screening check


This research may show that aerobic exercise, when taking correct responsibility for the varying insulin requirements, reduces the symptoms of T1DM. Even though this predominantly refers to med-high intensity over med-long duration, everyday occurrences will also have a positive effect on minimising symptoms of the disease. These may include:

  • Walking to work
  • Taking stairs rather than escalator/lift
  • Taking dog for a run on a more common basis


Precautions[edit]

Although research suggests that aerobic exercise is safe to participate in [4] some considerations must be taken:

  • Discuss intended training plan with doctor prior to commencing.
  • Frequently monitor blood-glucose levels during exercise.
  • Cease exercise if any abnormal symptoms appear.


Further Readings[edit]

References[edit]

  1. "Lernmark, Å. (1999). Type 1 diabetes. Clinical chemistry, 45(8), 1331-1338 http://www.clinchem.org/content/45/8/1331.full
  2. a b c d e "Eisenbarth, G. S. (1986). "Type I Diabetes Mellitus." New England Journal of Medicine 314(21): 1360-1368 http://www.hindawi.com/journals/ari/2012/457546/
  3. a b "National Health Survey, 1995, 2001, 2004-05 and 2007-08 http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/4820.0.55.001main+features32007-08
  4. a b "Zisser, H., Sueyoshi, M., Krigstein, K., Szigiato, A., & Riddell, M. C. (2012). Advances in exercise, physical activity and diabetes mellitus. International Journal Of Clinical Practice (Supplement), 6662-71. doi:10.1111/j.1742-1241.2011.02856.x http://www.yorku.ca/mriddell/documents/Zisseretal2012.pdf
  5. a b c d "Cohen ST, Jacobson AM. Psychological benefits of exercise. In: Ruderman NB, Devlin JT, Schneider SH, Kriska A, editors. Handbook of exercise in diabetes. 2nd ed. Alexandria, VA: American Diabetes Association; 2002 http://www.australianprescriber.com/magazine/30/5/article/911.pdf
  6. a b c "Pedersen, O., H. Beck-Nielsen, et al. (1980). "Increased Insulin Receptors after Exercise in Patients with Insulin-Dependent Diabetes Mellitus." New England Journal of Medicine 302(16): 886-892 http://www.nejm.org/doi/full/10.1056/NEJM198004173021603
  7. a b c d e f g "KOMATSU, W. R., BARROS NETO, T. L., CHACRA, A. R., & DIB, S. A. (2010). Aerobic Exercise Capacity and Pulmonary Function in Athletes With and Without Type 1 Diabetes. Diabetes Care, 33(12), 2555-2557. doi:10.2337/dc10-0769 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2992189/