Effect of Aerobic Physical Activity on Inflammatory and Autoimmune Parameters in Type 1 Diabetes

In a retrospective analysis of a type 1 diabetic (T1D) population, a subset of patients performing higher aerobic activity showed a reduced title of anti- GAD and anti-IA2 compared to sedentary T1D (Eur Rev Pharmacol Sci, 2015). For this reason we hypothesized that aerobic physical activity may positively regulate autoimmunity in diabetes. We tested this hypothesis in nonobese diabetic mice in a longitudinal study, confi rming the benefi cial immunomodulatory potential of aerobic physical activity (J Diabetes Res, 2015). This study focuses on the effects of a 3-month aerobic physical activity on metabolic, infl ammatory and autoimmune parameters in T1D patients on insulin pump therapy. Thirteen T1D patients, 4 sedentary (2M, 2F; 40.5±5.2 years; BMI 27.7±3.8) and 9 physically active (8M, 1F; 36.5±8.8 years; BMI 24.1±1.9), monitored with an insulin pump, were studied. At baseline and at the end of a 3-month aerobic physical activity, several blood parameters and markers, such as glycosylated hemoglobin (Hb1Ac), auto-antibodies (anti-GAD, anti-ZnT8, anti-IA2, ICA) and proinfl ammatory cytokines (IL-6 and TNF-α), were evaluated. After 3 months of training, physically active T1D patients, compared with the sedentary ones, showed a signifi cant reduction in Hb1Ac (-8.7%, p<0.01). Also, their Hb1Ac signifi cantly decreased compared to themselves at baseline (-10%, p<0.03). At the end of the study, anti-GAD titles were found signifi cantly lower in the active subjects compared with the sedentary ones (-74%, p<0.04). No signifi cant differences were observed as to the other autoantibodies and infl ammatory cytokines. This study confi rms the benefi cial role of physical exercise associated with insulin pump therapy in order to improve metabolic control without signifi cantly increasing hypoglycemic episodes. Preliminary positive results on autoimmune parameters need to be confi rmed in a prolonged follow-up.