Physical exercise and suppression of autoimmunity in type 1 diabetes. C-Peptide and the pathophysiology of diabetes – an update

For decades it has been known that regular aerobic exercise improves insulin sensitivity in diabetic patients, reducing insulin requirements. Traditionally, physical exercise has been promoted in Type 2 Diabetes, where insulin action is deficient in the context of insulin resistance and/or inappropriate insulin secretion. However, even in Type 1 Diabetes Mellitus (T1DM), in the dysregulation of immune system function, beta-cell toxicity is mediated by a complex interplay between oxidative stress and inflammation, for which exercise could be protective. Here, we collected immunological and metabolic data in T1DM patients (n=12, male, ± yrs) to understand whether exercise can favourably affect autoimmunity. A regression results analysis showed an inverse relationship between autoimmunity markers (GAD, IA) and weekly energy expenditure derived from physical exercise [Fig.1]. In another extensive analysis we found that regularly exercising T1DM-subjects have prolonged “honeymoon”, the early stage of the disease in which insulin requirements are latently lower than in advanced T1DM. These preliminary observations suggest that physical exercise may interfere with immune system function, even at low intensity and duration. Given its powerful ability to modulate oxidative stress and mitigate chronic inflammatory conditions, like those leading to autoimmunity diseases, we are going to design an exercise training program counteracting the autoimmune response which, in T1DM, attacks and destroys the insulin producing cells. Exercise emerges as a safe therapy against T1DM.