Active Subjects with Autoimmune Type 1 Diabetes Have Better Metabolic Profiles than Sedentary Controls

Previous studies in humans with type 1 diabetes (T1D) and in non-obese diabetic mice have investigated the beneficial immunomodulatory potential of aerobic physical activity. Performing high volume of aerobic exercise may favorably regulate autoimmunity in diabetes. We tested whether increased physical activity is a self-sufficient positive factor in T1D subjects. During a 3-month observational period, active (6M; 40.5\ub16.1 years; BMI 24.5\ub12.1) and sedentary (4M, 3F; 35.9\ub18.9 years; BMI 25.7\ub13.8) T1D individuals on insulin pump therapy were studied for metabolic, inflammatory and autoimmune parameters. At baseline and at the end of a 3-month period, glycosylated hemoglobin (HbA1c), auto-antibodies (anti-GAD, anti-ZnT8, anti-IA2, ICA) and pro-inflammatory cytokines (IL-6 and TNF-\u3b1) were evaluated. During the 3rd month of the period, physically active T1D patients showed a significant reduction in the average glucose levels (-9%, p=0.025, by CGM) compared to the 1st-month values, and even their hyperglycemic episodes (>180mg/dL) diminished significantly (-24.2%, p=0.032 vs 1st month). Moreover, active T1D subjects exhibited an improved body composition with respect to sedentary controls. No significant changes were detected as to the autoimmune and inflammatory profiles. This study confirms the beneficial role of physical exercise associated with insulin pump therapy in order to improve metabolic control in individuals with T1D. These preliminary positive observations need to be challenged in a prolonged interventional follow-up