Effects of non-supervised low intensity aerobic excise training on the microvascular endothelial function of patients with type 1 diabetes: a non-pharmacological interventional study

Abstract

BackgroundThe aim of the present study was to evaluate changes in microvascular density and reactivity in patients with type 1 diabetes (T1D) resulting from low intensity chronic exercise training.MethodsThis study included 22 (34 ± 7 years) consecutive outpatients with T1D and disease duration > 6 years. We used intravital video-microscopy to measure basal skin capillary density and capillary recruitment using post-occlusive reactive hyperemia (PORH) in the dorsum of the fingers. Endothelium-dependent and -independent vasodilation of the skin microcirculation was evaluated in the forearm with a laser Doppler flow monitoring (LDF) system in combination with acetylcholine and sodium nitroprusside iontophoresis, PORH and local thermal hyperemia.ResultsThe basal mean capillary density (MCD) after exercise training was significantly higher than before exercise (134 ± 25 vs. 119 ± 19 capillaries/mm2, respectively; P = 0.0013). MCD during PORH was also higher after exercise (140 ± 26 vs. 121 ± 24 capillaries/mm2, respectively; P < 0.0001). Endothelium-dependent capillary recruitment during PORH was also significantly higher after exercise (140 ± 26 vs. 134 ± 25 capillaries/mm2, respectively; P < 0.0012). There were no significant changes in skin microvascular reactivity after exercise as investigated using LDF.ConclusionsOur results showed that low intensity aerobic exercise, performed four times per week for 12 weeks by patients with T1D, induces significant increases in microvascular density and endothelial-dependent capillary reactivity.Trial registrationClinicalTrials.gov NCT02441504. Registered 7 May 2015.Electronic supplementary materialThe online version of this article (doi:10.1186/s12872-016-0191-9) contains supplementary material, which is available to authorized users.

Assessing the evidence: Exploring the effects of exercise on diabetic microcirculation

“…Nevertheless, they did not assess other markers such as oxidative stress or inflammation markers which also affect vascular function. Contrary to the observations of Roche et al, a four-week low intensity aerobic training programme in DM1 patients did not affect skin microvascular reativity, as assessed by local heating, PORH and iontophoresis of ACh and SNP [39]. On the other hand, capillary density in response to PORH, assessed by dynamic capillaroscopy, was increased in the same group of patients [39].…”

Increased vascular function and superoxide dismutase activity in physically active vs inactive adults living with HIV

“…Benefits of exercise training on vascular function have been also reported in individuals with and without cardiovascular disease . For instance, our group has already reported that low‐intensity aerobic exercise training, performed at least three times per week, increased endothelial‐dependent capillary reactivity in patients with type 1 diabetes and coronary artery disease . Prior research has also demonstrated that exercise training improved endothelial function in adolescents with type 2 diabetes and chronic heart failure, compared to sedentary patients who received only standard clinical care.…”

The impact of exercise frequency upon microvascular endothelium function and oxidative stress among patients with coronary artery disease

“…In respect to cardio‐metabolic diseases, de Moraes et al . () reported that skin microvascular density and endothelium‐dependent capillary recruitment were increased in patients with diabetes after twelve weeks of exercise training performed four times per week. On the other hand, Olsen et al .…”

“…Hodges et al (2010), for instance, observed that three exercise sessions/week for 48 weeks in postmenopausal women increased peak cutaneous endothelial-dependent vasodilation in response to acetylcholine iontophoresis measured by laser-Doppler flowmetry. In respect to cardio-metabolic diseases, de Moraes et al (2016) reported that skin microvascular density and endothelium-dependent capillary recruitment were increased in patients with diabetes after twelve weeks of exercise training performed four times per week. On the other hand, Olsen et al (2015) demonstrated that three weekly sessions of aerobic interval exercise for 12 weeks did not change systemic vascular function measured by arterial tonometry in patients with CAD.…”