Frequent and intensive physical activity reduces risk of cardiovascular events in type 1 diabetes

Abstract

Aims/hypothesis Cardiovascular disease (CVD) is the most common cause of premature death and disability among patients with type 1 diabetes. Diabetic nephropathy accounts for the increased cardiovascular morbidity and mortality of these patients. We recently showed that the intensity of exercise predicts the incidence and progression of diabetic nephropathy in patients with type 1 diabetes. Little is known about the relationship between physical activity and CVD. Therefore, we studied how physical activity affects the risk of CVD events in patients with type 1 diabetes. Methods A 10 year follow-up study including 2180 type 1 diabetes patients from the nationwide multicentre Finnish Diabetic Nephropathy Study (FinnDiane). Leisure time physical activity (LTPA) was assessed by a previously validated self-report questionnaire. A CVD event was defined as a verified myocardial infarction, coronary procedure or stroke. Patients were analysed separately for the risk of developing a first ever CVD event and for the risk of a recurrent CVD event following a baseline event.Results A total of 206 patients had an incident CVD event during follow-up. A higher total LTPA and higher intensity, frequency and duration of activity were associated with a lower risk of incident CVD events. The observed association between exercise frequency and incident CVD remained significant when adjusted for classic risk factors. Exercise intensity also had a borderline effect on the recurrence-free time in patients with a major CVD event at baseline. Conclusions/interpretation This study suggests that exercise, particularly high frequency and high intensity exercise, may reduce the risk of CVD events in patients with type 1 diabetes.

Physical Activity and Diabetes

“…Randomized trials have found that supervised exercise interventions improve glycated hemoglobin (A1C) (6)(7)(8), triglycerides (TG) and cholesterol (9) in people with type 2 diabetes when compared to no exercise comparison groups (10). Cohort studies have demonstrated that, in people with type 2 (11)(12)(13), and with type 1 diabetes (14,15), regular physical activity (11)(12)(13) and/or moderate to high cardiorespiratory fitness (16) are associated with reductions in cardiovascular (CV) and overall mortality.…”

High‐Intensity Exercise Reduces Cardiac Fibrosis and Hypertrophy but Does Not Restore the Nitroso‐Redox Imbalance in Diabetic Cardiomyopathy

“…Nevertheless, there is less information regarding type 1 diabetic patients. A recent report indicates that intense exercise is associated to reduction in the risk of cardiovascular events in type 1 diabetes patients [16]. In animal models of type 1 diabetes, low-to-moderate exercise training has been found to improve cardiac glucose metabolism [17], reduce apoptosis [18], and improve ventricular function [19].…”

Risk factors of hypoglycaemia in type 1 diabetes individuals during intensive sport exercise—Data from the SPORTGIVECHANCE event

“…Next, regular physical activity reduces insulin resistance and insulin requirement, it also results in improvement in lipid profile and endothelial function . Finally, physically active people with T1DM are less likely to develop macrovascular complications and have lower mortality rates . A recently published cross‐sectional multicentre study on 18 028 T1DM individuals showed that physical activity improved long‐term glycaemic control .…”