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Why should people with type 1 diabetes exercise regularly?

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Abstract

Plethoric evidence reminds of the protective effects of exercise against a number of health risks, across all ages, in the general population. The benefits of exercise for individuals with type 2 diabetes are indisputable. An in-depth understanding of energy metabolism has reasonably entailed exercise as a cornerstone in the lifestyle of almost all subjects with type 1 diabetes. Nevertheless, individuals with type 1 diabetes often fail in accomplishing exercise guidelines and they are less active than their peer without diabetes. Two major obstacles are feared by people with type 1 diabetes who wish to exercise regularly: management of blood glucose control and hypoglycemia. Nowadays, strategies, including glucose monitoring technology and insulin pump therapy, have significantly contributed to the participation in regular physical activity, and even in competitive sports, for people with type 1 diabetes. Novel modalities of training, like different intensity, interspersed exercise, are as well promising. The beneficial potential of exercise in type 1 diabetes is multi-faceted, and it has to be fully exploited because it goes beyond the insulin-mimetic action, possibly through immunomodulation.

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Abbreviations

CGM:

Continuous glucose monitoring

CSII:

Continuous subcutaneous insulin infusion

CVD:

Cardiovascular disease

GLP-1:

Glucagon-like peptide-1

IL-6:

Interleukin 6

IMCL:

Intramyocellular lipid content

IT:

Islet transplantation

MDII:

Multiple daily insulin injections

NEFA:

Non-esterified fatty acid

SMBG:

Self-monitoring blood glucose

T1D:

Type 1 diabetes

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Acknowledgements

The authors would like to thank Michela Adamo for having reviewed the manuscript thoroughly.

Author contributions

All authors were responsible for drafting the manuscript and revising it critically for valuable intellectual content. All authors approved the version to be published.

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This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Biomedical Sciences for Health, University of Milan, Via F.lli Cervi 93, Segrate, 20090, Milan, Italy

    Roberto Codella & Livio Luzi

  2. Diabetes Research Institute, Metabolism, Nutrigenomics and Cellular Differentiation Unit, San Raffaele Scientific Institute, Milan, Italy

    Ileana Terruzzi

  3. Metabolism Research Center, IRCCS Policlinico San Donato, San Donato Milanese, Italy

    Livio Luzi

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  1. Roberto Codella
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  2. Ileana Terruzzi
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  3. Livio Luzi
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Correspondence to Roberto Codella.

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All human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki. As to the reports on animal experiments, “Principles of laboratory animal care” (NIH publication No. 86-23, revised 1985) were followed, as well as specific national laws.

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Codella, R., Terruzzi, I. & Luzi, L. Why should people with type 1 diabetes exercise regularly?. Acta Diabetol 54, 615–630 (2017). https://doi.org/10.1007/s00592-017-0978-x

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