Physical Activity in the Prevention of Development and Progression of Kidney Disease in Type 1 Diabetes

Abstract

Purpose of Review Physical activity is a fundamental part of lifestyle management in diabetes care. Although its benefits are very well recognized in the general population and in people with type 2 diabetes, much less is known about the effects of exercise in type 1 diabetes. In particular, exercise effects in relation to diabetic kidney disease (DKD) are understudied. Some uncertainties about physical activity recommendations stem from the fact that strenuous exercise may worsen albuminuria immediately after the activity. However, in middle-aged and older adults without diabetes, observational studies have suggested that physical activity is associated with a decreased risk of rapid kidney function deterioration. In this review, we focus on the role of physical activity in patients with DKD and type 1 diabetes. Recent Findings Hereby, we present data that show that in individuals at risk of DKD or with established DKD, regular moderate-to-vigorous physical activity was associated with reduced incidence and progression of DKD, as well as reduced risk of cardiovascular events and mortality. Summary Therefore, regular moderate-to-vigorous exercise should become a central part of the management of individuals with type 1 diabetes, in the absence of contraindications and accompanied with all needed educational support for optimal diabetes management.

Impact of interval walking training managed through smart mobile devices on albuminuria and leptin/adiponectin ratio in patients with type 2 diabetes

“…We suppose that albuminuria could be used in clinical practice as a biomarker of cardioprotective effects of physical training for patient motivation. Promising data about the effects of physical activity on progression of complications of diabetes have been obtained previously (Pongrac Barlovic et al, 2019;Tikkanen-Dolenc et al, 2017).…”

“…Physical activity is the first-line treatment in type 2 diabetes (Colberg et al, 2016;Pai et al, 2016). Recently, promising data about the positive impact of physical activity on the vascular complications of diabetes have emerged (Lin, Peng, Chiou, & Huang, 2014;Pongrac Barlovic, Tikkanen-Dolenc, & Groop, 2019;Tikkanen-Dolenc et al, 2017). Moreover, it has been shown that physical activity is associated with the reduction in albuminuria (Hellberg, Höglund, Svensson, & Clyne, 2019).…”

Advantages of physical activity of varying intensity for patients with type 1 diabetes and its influence on glucose metabolism

“…Физически активные пациенты с диабетической нефропатией имеют практически в 2 раза более низкий риск смертности по сравнению с неактивными [8]. Физические нагрузки не только не противопоказаны пациентам с хронической болезнью почек, но и проводятся у пациентов на фоне диализа, улучшая прогноз заболевания [38]. Следует начинать тренировки с упражнений низкой интенсивности и продолжительности и контролировать уровень электролитов во время проведения сеансов диализа [2].…”

“…Пациентам с пролиферативной или тяжелой непролиферативной диабетической ретинопатией противопоказаны силовые тренировки и интенсивные упражнения или соревнования на выносливость из-за риска спровоцировать кровоизлияние в стекловидное тело или отслойку сетчатки [38]; гемофтальм, отслойка сетчатки, первые полгода после лазеркоагуляции сетчатки являются ограничениями для любых видов физических упражнений [39].…”

<p>The Athlete with Type 1 Diabetes: Transition from Case Reports to General Therapy Recommendations</p>

“…−14 Increased physical activity frequency10−12,14 and intensity13 are associated with a lower incidence and prevalence of cardiovascular disease and cardiovascular disease risk factors 14. They are also associated with a decreased frequency and severity of diabetes complications,15–18 increased life expectancy16–18 and improved quality of life19,20 in this population. Unfortunately, if not properly managed physical activity and exercise can cause large and rapid declines in blood glucose, increasing the risk of hypoglycemia during exercise, and can also cause hyperglycemia post-exercise for several hours 21.…”