Combining exercise with hypoxia may allow more effective short-term glycaemic control in T1D. Intermittent exercise with hypoxia could stabilize the secretion of selected proangiogenic factors and reduce inflammation, potentially leading to improved vascular function.

Any new method of treatment is associated with high expectations for its success, particularly if the therapy is based not only on the premise of achieving a symptomatic effect, but also improving functional quality and repairing structurally damaged tissues. Platelet Rich Plasma (PRP) application was shown to be a successful catalyst in the healing process for a wide variety of conditions in animal and human models. However, its use has been controversial due to many types of the PRP definition, optimal concentration, and modalities of implementation. In the qualification of patients for PRP treatment, not only should medical indications be considered, but also the role of participation in therapy with a physiotherapist supervising physical parameters and techniques used during recovery time. Further study is required in order to define optimal handling procedures of PRP injection. Long-term follow up will reveal if the promise of this substance can be realized and implemented to maximize its potential as a therapeutic remedy.

Aim: This study aimed to determine the effect of moderate intensity continuous exercise (Ex) and hypoxia (Hyp) on serum brain-derived neurotrophic factor (BDNF), insulin-like growth factor-1 (IGF-1) and its binding protein-3 (IGFBP-3), irisin and cytokines levels in patients with type 1 diabetes (T1D). Methods: A total of 14 individuals with T1D (age: 28.7 ± 7.3 years) and 14 healthy adults (age: 27.1 ± 3.9 years) performed 40-min continuous Ex at moderate intensity (50% lactate threshold) on a cycle ergometer in normoxia (Nor) and Hyp (FiO2 = 15.1%) Biochemical factors, glucose concentrations and physiological variables were measured at rest, immediately and up to 24 h after both Ex protocols. Results: Patients with T1D had significantly lower pre-Ex serum concentrations of BDNF ( p < 0.05, p < 0.01), and total IGF-1 ( p < 0.001, p < 0.05) and significantly higher irisin levels ( p < 0.05, p < 0.01) in Nor and Hyp, compared with healthy subjects. Ex significantly increased in T1D group serum BDNF (in Nor only p < 0.05) and total IGF-1 levels in Nor and Hyp ( p < 0.001 and p < 0.01, respectively). Immediately after Ex in Hyp, freeIGF-1 ( p < 0.05) and irisin levels ( p < 0.001) were significantly higher compared with the levels induced by Ex alone. Free IGF-1 and irisin serum levels remained elevated in 24 h post-Ex in Hyp. In T1D, significant blood glucose (BG) decrease was observed immediately after Ex in Hyp ( p < 0.001) and in 24 h recovery ( p < 0.001) compared with pre-Ex level. Conclusion: The study results suggest that moderate intensity continuous Ex has beneficial effect on BDNF and IGF-1 levels. Ex in hypoxic conditions may be more effective in increasing availability of IGF-1. The alterations in the post-Ex irisin levels and IGF-1 system may be contributing to more effective glycaemia control in patients with T1D.

The presented method seems technically simple, effective and relatively inexpensive.

IntroductionAccording to scientific reports cardiovascular complications are the leading cause of death in people with diabetes (Stirban and Tschoepe 2008). It has been shown that chronically elevated blood glucose concentration is mainly responsible for the development of micro-and/or macroangiopathy (American Diabetes Association 2009). Angiogenesis is mainly stimulated by hypoxia, and more specifically by hypoxia inducible factor-1 alpha (HIF-1α) the main proangiogenic factor -vascular-endothelial growth factor (VEGF). In diabetes chronic exposure to hyperglycemia modifies the function these main angiogenic factors (Simons et al. 2005). Studies suggest that combining physical activity with hypoxia improves glycaemic control (D'hooge et al. 2011;Mackenzie et al. 2012) and to have beneficial effect on vascular function (Fuchsjäger-Mayrl et al. 2002,). Therefore, the aim of the study was to assess the effect of moderate intensity continuous exercise in normobaric hypoxia on glycaemic control and concentration of proangiogenic factors in patients with Type 1 diabetes. Methods: Twelve patients (age: 29.2±9.5 years) suffering from Type 1 diabetes (T1D) for 12.1±6.0 years, with HbA1c at approximately 56.3mmol/mol, free of diabetic complications, and twelve randomly chosen adults (GC) without diabetes performed the 40 min continuous exercise (ExC) of moderate intensity (50% of lactate threshold load). The exercise tests were performed in normoxia and normobaric hypoxia, which simulated the altitude of 2500 m a.s.l. Serum glucose, proangiogenic factors, and brain-derived neurotrophic factor (BDNF) concentrations were measured at rest, immediately and up to 24 h after exercise. Results: A significant decrease in serum glucose concentration was observed immediately after ExC in hypoxia (p<0.001) and normoxia (p<0.05). Continuous exercise in hypoxia caused the greatest decline in blood glucose (mean Δ glucose: 83.6±13.3 mg/dl) and had the most beneficial effect on moderate-term (up to 24 h) glucose control. A significantly higher baseline serum concentrations of HIF-1α were showed in the group of individuals with T1D in comparison with healthy subjects (p<0.05). ExC in normoxia (p<0.001) and hypoxia (p<0.05) significantly increased the level of BDNF in T1D. A tendency TNF-α level reduction was observed in T1D in response to Ex. No significant modifications in concentrations of other proangiogenic factors were stated in response to exercise tests. Conclusions The significant glycaemia reduction induced by continuous exercise in hypoxia with a tendency to reduction of pro-inflammatory cytokine level suggest that physical exertions of different intensity combined with exposure to hypoxia may improve metabolic control and stabilize the process of angiogenesis decreasing the risk of severe vascular complications in patients with Type 1 diabetes.

The aim of this study was to evaluate somatic, hormonal and immunological changes during the macrocycle of cyclists (9 well-trained men, age 25.6 ± 5.2 years and body weight 72.4 ± 7.35 kg). During the training macrocycle, four exercise control tests were carried out, and biochemical markers were measured in the laboratory. Seasonal training changes did not significantly disturb resting somatic and functional parameters, physical capacity (VO2max), body weight, the number of leukocytes and selected hormones. The secretory system of the organism did not respond significantly to the exercise stress in the training process, even with the increasing share of anaerobic processes in the subsequent periods of the macrocycle. Irisin and other parameters globally did not correlate with training volume. Irisin showed a significant correlation only with cortisol in the first period and human growth hormone in the second, and it showed a weak correlation in the third period with body mass and BMI. The lack of interactions between irisin level and other variables practically excludes its use in monitoring cyclist training. Future research would be complemented by the assessment of stress and postexercise changes in the cyclists’ macrocycle and expanding the research group to other athletes, including women.

Purpose. Physical activity is an integral part of the treatment of diabetes. The aim of the study was to assess aerobic capacity and cardiovascular-respiratory reactions to a single physical exercise with gradually increasing intensity in normobaric hypoxia in patients with Type 1 diabetes. Methods. The study was conducted on a sample of adults with Type 1 diabetes (GT1D, n = 13) and a randomly chosen healthy control (GK, n = 15). The study participants performed a progressive exercise test to exhaustion in normoxia (FiO