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Moustafa Mahmoud M, Abdel Hameed NQ, Adel Al Dreny Abd Al Latef B, Samir Kamar S, Ahmed Rashed L, Abdelhameed Gouda SA. High-intensity exercise alongside insulin alleviates muscle atrophy in type 1 diabetes mellitus concomitant with modulation of mitophagy-related proteins in skeletal muscle. Arch Physiol Biochem 2024:1-13. [PMID: 39382178 DOI: 10.1080/13813455.2024.2410791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Revised: 08/08/2024] [Accepted: 09/15/2024] [Indexed: 10/10/2024]
Abstract
Background: Diabetes patients' quality of life can be severely impacted by diabetic muscle atrophy.Aim: This study aimed to explore the impact of high-intensity exercise (HIE) alongside insulin treatment on muscle atrophy in a rat model of type 1 diabetes mellitus (T1DM).Methodology: Fifty rats were allocated into five groups; Group 1, control sedentary (CS), T1DM was elicited in the rest of the groups by giving them Streptozotocin (STZ) (60 mg/kg), where group 2 (DS) remained sedentary, while groups 3,4,5 were treated with insulin after induction of diabetes. Group 4 (DI+MIE) and 5 (DI+ HIE) underwent moderate and high-intensity exercise, respectively.Results: HIE for 14 days combined with insulin treatment significantly restored muscle strength and mass with a significant modification in the mitophagy-related proteins and fibroblast growth factor 21 (FGF 21) compared to other treated groups.Conclusion: This study concluded that there is a therapeutic role for HIE with insulin against T1DM-induced muscle atrophy.
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Affiliation(s)
| | | | | | - Samaa Samir Kamar
- Histology department, Faculty of Medicine- Cairo University, Cairo, Egypt
- Histology department, Armed Forces College of Medicine, Cairo, Egypt
| | - Laila Ahmed Rashed
- Department of Medical Biochemistry, Faculty of Medicine, Cairo University, Cairo, Egypt
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Valli G, Wu R, Minnock D, Sirago G, Annibalini G, Casolo A, Del Vecchio A, Toniolo L, Barbieri E, De Vito G. Can non-invasive motor unit analysis reveal distinct neural strategies of force production in young with uncomplicated type 1 diabetes? Eur J Appl Physiol 2024:10.1007/s00421-024-05595-z. [PMID: 39212731 DOI: 10.1007/s00421-024-05595-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Accepted: 08/23/2024] [Indexed: 09/04/2024]
Abstract
PURPOSE to investigate the early consequences of type 1 diabetes (T1D) on the neural strategies of muscle force production. METHODS motor unit (MU) activity was recorded from the vastus lateralis muscle with High-Density surface Electromyography during isometric knee extension at 20 and 40% of maximum voluntary contraction (MVC) in 8 T1D (4 males, 4 females, 30.5 ± 3.6 years) and 8 matched control (4 males, 4 females, 27.3 ± 5.9 years) participants. Muscle biopsies were also collected from vastus lateralis for fiber type analysis, including myosin heavy chain (MyHC) isoform content via protein and mRNA expression. RESULTS MVC was comparable between groups as well as MU conduction velocity, action potentials' amplitude and proportions of MyHC protein isoforms. Nonetheless, MU discharge rate, relative derecruitment thresholds and mRNA expression of MyHC isoform I were lower in T1D. CONCLUSIONS young people with uncomplicated T1D present a different neural control of muscle force production. Furthermore, differences are detectable non-invasively in absence of any functional manifestation (i.e., force production and fiber type distribution). These novel findings suggest that T1D has early consequences on the neuromuscular system and highlights the necessity of a better characterization of neural control in this population.
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Affiliation(s)
- Giacomo Valli
- Department of Biomedical Sciences, University of Padova, Padua, Italy
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Rui Wu
- School of Electrical and Electronic Engineering, University College Dublin, Belfield, Dublin 4, Ireland
| | - Dean Minnock
- School of Electrical and Electronic Engineering, University College Dublin, Belfield, Dublin 4, Ireland.
| | - Giuseppe Sirago
- Department of Biomedical Sciences, University of Padova, Padua, Italy
- Institute of Sport Sciences and Department of Biomedical Sciences, University of Lausanne, Lausanne, Switzerland
| | - Giosuè Annibalini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Andrea Casolo
- Department of Biomedical Sciences, University of Padova, Padua, Italy
| | - Alessandro Del Vecchio
- Department Artificial Intelligence in Biomedical Engineering, Friedrich-Alexander University, Erlangen, Germany
| | - Luana Toniolo
- Department of Biomedical Sciences, University of Padova, Padua, Italy
| | - Elena Barbieri
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Giuseppe De Vito
- Department of Biomedical Sciences, University of Padova, Padua, Italy
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Sammut MJ, Dotzert MS, Melling CWJ. Mechanisms of insulin resistance in type 1 diabetes mellitus: A case of glucolipotoxicity in skeletal muscle. J Cell Physiol 2024:e31419. [PMID: 39192756 DOI: 10.1002/jcp.31419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Revised: 07/16/2024] [Accepted: 08/09/2024] [Indexed: 08/29/2024]
Abstract
Insulin resistance (IR), a hallmark of type 2 diabetes mellitus, develops in a significant number of patients with type 1 diabetes mellitus (T1DM) despite the use of insulin therapy to control glycemia. However, little is currently understood regarding the underlying mechanisms of IR in T1DM, especially within the context of chronic insulin treatment. Recent evidence suggests an important influence of glucolipotoxicity in skeletal muscle on insulin sensitivity in T1DM. Thus, this review summarizes our current knowledge regarding impairments in skeletal muscle lipid, glucose, and oxidative metabolism in the development of IR in insulin-treated T1DM.
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Affiliation(s)
- Mitchell J Sammut
- School of Kinesiology, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Michelle S Dotzert
- School of Kinesiology, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - C W James Melling
- School of Kinesiology, Faculty of Health Sciences, Western University, London, Ontario, Canada
- Department of Physiology & Pharmacology, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
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Rebalka IA, Noguchi KS, Bulyovsky KR, Badour MI, Juracic ES, Barrett K, Brahmbhatt A, Al-Khazraji B, Punthakee Z, Perry CGR, Kumbhare DA, MacDonald MJ, Hawke TJ. Targeting skeletal muscle health with exercise in people with type 1 diabetes: A protocol for HOMET1D, a prospective observational trial with matched controls. PLoS One 2024; 19:e0303448. [PMID: 38776307 PMCID: PMC11111001 DOI: 10.1371/journal.pone.0303448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 04/17/2024] [Indexed: 05/24/2024] Open
Abstract
INTRODUCTION Individuals with type 1 diabetes (T1D) experience a complex set of alterations to skeletal muscle metabolic, neuromuscular, and vascular health; collectively referred to as diabetic myopathy. While the full scope of diabetic myopathy is still being elucidated, evidence suggests that even when individuals with T1D are physically active, indices of myopathy still exist. As such, there is a question if adherence to current physical activity guidelines elicits improvements in skeletal muscle health indices similarly between individuals with and without T1D. The objectives of this trial are to: 1) compare baseline differences in skeletal muscle health between adults with and without T1D, 2) examine the association between participation in a home-based exercise program, detraining, and retraining, with changes in skeletal muscle health, and 3) examine the roles of age and sex on these associations. METHODS AND ANALYSIS This will be a prospective interventional trial. Younger (18-30 years) and older (45-65 years) males and females with T1D and matched individuals without T1D will engage in a four-phase, 18-week study sequentially consisting of a one-week lead-in period, 12-week exercise training program, one-week detraining period, and four-week retraining period. The exercise program will consist of aerobic and resistance exercise based on current guidelines set by Diabetes Canada. Metabolic, neuromuscular, and vascular outcome measures will be assessed four times: at baseline, post-exercise program, post-detraining, and post-retraining. Differences in baseline metrics between those with and without T1D will be examined with independent sample t-tests, and with two-way analyses of variance for age- and sex-stratified analyses. Changes across the duration of the study will be examined using mixed-model analyses. DISSEMINATION Findings from this research will be shared locally and internationally with research participants, clinicians, diabetes educators, and patient advocacy organizations via in-person presentations, social media, and scientific fora. TRIAL REGISTRATION NUMBER NCT05740514.
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Affiliation(s)
- Irena A. Rebalka
- Department of Pathology & Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Kenneth S. Noguchi
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Kayla R. Bulyovsky
- Department of Pathology & Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Matthew I. Badour
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Emma S. Juracic
- Department of Pathology & Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Khandra Barrett
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Aditya Brahmbhatt
- School of Kinesiology & Health Science, Muscle Health Research Centre, York University, Toronto, Ontario, Canada
| | - Baraa Al-Khazraji
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Zubin Punthakee
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Christopher G. R. Perry
- School of Kinesiology & Health Science, Muscle Health Research Centre, York University, Toronto, Ontario, Canada
| | - Dinesh A. Kumbhare
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | - Thomas J. Hawke
- Department of Pathology & Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
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Sammut MJ, McBey DP, Sayal AP, Melling CWJ. The Effects of Resistance Exercise Training on Skeletal Muscle Metabolism and Insulin Resistance Development in Female Rodents with Type 1 Diabetes. J Diabetes Res 2024; 2024:5549762. [PMID: 38435452 PMCID: PMC10904684 DOI: 10.1155/2024/5549762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 03/05/2024] Open
Abstract
The etiology of insulin resistance (IR) development in type 1 diabetes mellitus (T1DM) remains unclear; however, impaired skeletal muscle metabolism may play a role. While IR development has been established in male T1DM rodents, female rodents have yet to be examined in this context. Resistance exercise training (RT) has been shown to improve IR and is associated with a lower risk of hypoglycemia onset in T1DM compared to aerobic exercise. The purpose of this study was to investigate the effects of RT on IR development in female T1DM rodents. Forty Sprague Dawley eight-week-old female rats were divided into four groups: control sedentary (CS; n = 10), control trained (CT; n = 10), T1DM sedentary (DS; n = 10), and T1DM trained (DT; n = 10). Multiple low-dose streptozotocin injections were used to induce T1DM. Blood glucose levels were maintained in the 4-9 mmol/l range with intensive insulin therapy. CT and DT underwent weighted ladder climbing 5 days/week for six weeks. Intravenous glucose tolerance tests (IVGTT) were conducted on all animals following the six-week period. Results demonstrate that DS animals exhibited significantly increased weekly blood glucose measures compared to all groups including DT (p < 0.0001), despite similar insulin dosage levels. This was concomitant with a significant increase in insulin-adjusted area under the curve following IVGTT in DS (p < 0.05), indicative of a reduction in insulin sensitivity. Both DT and DS exhibited greater serum insulin concentrations compared to CT and CS (p < 0.05). DS animals also exhibited significantly greater glycogen content in white gastrocnemius muscle compared to CS and DT (p < 0.05), whereas DT and DS animals exhibited greater p-Akt: Akt ratio in the white vastus lateralis muscle and citrate synthase activity in the red vastus lateralis muscle compared to CS and CT (p < 0.05). These results indicate that female rodents with T1DM develop poor glycemic control and IR which can be attenuated with RT, possibly related to differences in intramyocellular glycogen content.
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Affiliation(s)
- Mitchell J. Sammut
- School of Kinesiology, Faculty of Health Sciences, Western University, London, ON, Canada
| | - David P. McBey
- School of Kinesiology, Faculty of Health Sciences, Western University, London, ON, Canada
| | - Amit P. Sayal
- School of Kinesiology, Faculty of Health Sciences, Western University, London, ON, Canada
| | - C. W. James Melling
- School of Kinesiology, Faculty of Health Sciences, Western University, London, ON, Canada
- Department of Physiology & Pharmacology, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
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Abstract
Regular physical activity improves cardiometabolic and musculoskeletal health, helps with weight management, improves cognitive and psychosocial functioning, and is associated with reduced mortality related to cancer and diabetes mellitus. However, turnover rates of glucose in the blood increase dramatically during exercise, which often results in either hypoglycaemia or hyperglycaemia as well as increased glycaemic variability in individuals with type 1 diabetes mellitus (T1DM). A complex neuroendocrine response to an acute exercise session helps to maintain circulating levels of glucose in a fairly tight range in healthy individuals, while several abnormal physiological processes and limitations of insulin therapy limit the capacity of people with T1DM to exercise in a normoglycaemic state. Knowledge of the acute and chronic effects of exercise and regular physical activity is critical for the formulation of clinical strategies for the management of insulin and nutrition for active patients with T1DM. Emerging diabetes-related technologies, such as continuous glucose monitors, automated insulin delivery systems and the administration of solubilized glucagon, are demonstrating efficacy for preserving glucose homeostasis during and after exercise in this population of patients. This Review highlights the beneficial effects of regular exercise and details the complex endocrine and metabolic responses to different types of exercise for adults with T1DM. An overview of basic clinical strategies for the preservation of glucose homeostasis using emerging technologies is also provided.
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Affiliation(s)
- Michael C Riddell
- Muscle Health Research Centre, School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada.
- LMC Diabetes and Endocrinology, Toronto, Ontario, Canada.
| | - Anne L Peters
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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O’Neill CC, Locke EJ, Sipf DA, Thompson JH, Drebushenko EK, Berger NS, Segich BS, Kolwicz SC. The Effects of Exercise Training on Glucose Homeostasis and Muscle Metabolism in Type 1 Diabetic Female Mice. Metabolites 2022; 12:metabo12100948. [PMID: 36295850 PMCID: PMC9608674 DOI: 10.3390/metabo12100948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/26/2022] [Accepted: 10/01/2022] [Indexed: 01/13/2023] Open
Abstract
Although exercise training is an important recommendation for the management of type 1 diabetes (T1D), most of the available research studies predominantly focus on male subjects. Given the importance of sex as a biological variable, additional studies are required to improve the knowledge gap regarding sex differences in T1D research. Therefore, the purpose of this study was to examine the role of exercise training in mediating changes in glucose homeostasis and skeletal muscle metabolism in T1D female mice. Female mice were injected with streptozotocin (STZ) to induce T1D. Two weeks after STZ injection, control (CON) and STZ mice were exercise trained on a treadmill for 4 weeks. Aerobic exercise training failed to improve glucose tolerance, prevent the decrease in body weight and adipose tissue mass, or attenuate muscle atrophy in T1D female mice. However, insulin sensitivity was improved in T1D female mice after exercise training. Aerobic exercise training maintained skeletal muscle triglyceride content but did not prevent depletion of skeletal muscle or liver glycogen in T1D mice. Gene expression analysis suggested that T1D resulted in decreased glucose transport, decreased ketone body oxidation, and increased fatty acid metabolism in the skeletal muscle, which was not altered by exercise training. These data demonstrate that 4 weeks of aerobic exercise training of a moderate intensity is insufficient to counteract the negative effects of T1D in female mice, but does lead to an improvement in insulin sensitivity.
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Maschari D, Saxena G, Law TD, Walsh E, Campbell MC, Consitt LA. Lactate-induced lactylation in skeletal muscle is associated with insulin resistance in humans. Front Physiol 2022; 13:951390. [PMID: 36111162 PMCID: PMC9468271 DOI: 10.3389/fphys.2022.951390] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 07/25/2022] [Indexed: 11/17/2022] Open
Abstract
Elevated circulating lactate has been associated with obesity and insulin resistance. The aim of the current study was to determine if lactate-induced lysine lactylation (kla), a post-translational modification, was present in human skeletal muscle and related to insulin resistance. Fifteen lean (Body Mass Index: 22.1 ± 0.5 kg/m2) and fourteen obese (40.6 ± 1.4 kg/m2) adults underwent a muscle biopsy and 2-h oral glucose tolerance test. Skeletal muscle lactylation was increased in obese compared to lean females (19%, p < 0.05) and associated with insulin resistance (r = 0.37, p < 0.05) in the whole group. Skeletal muscle lactylation levels were significantly associated with markers of anaerobic metabolism (plasma lactate and skeletal muscle lactate dehydrogenase [LDH], p < 0.05) and negatively associated with markers of oxidative metabolism (skeletal muscle cytochrome c oxidase subunit 4 and Complex I [pyruvate] OXPHOS capacity, p < 0.05). Treatment of primary human skeletal muscle cells (HSkMC) with sodium lactate for 24 h increased protein lactylation and IRS-1 serine 636 phosphorylation in a similar dose-dependent manner (p < 0.05). Inhibition of glycolysis (with 2-deoxy-d-glucose) or LDH-A (with sodium oxamate or LDH-A siRNA) for 24 h reduced HSkMC lactylation which paralleled reductions in culture media lactate accumulation. This study identified the existence of a lactate-derived post-translational modification in human skeletal muscle and suggests skeletal muscle lactylation could provide additional insight into the regulation of skeletal muscle metabolism, including insulin resistance.
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Affiliation(s)
- Dominic Maschari
- College of Health Sciences and Professions, Ohio University, Athens, OH, United States
| | - Gunjan Saxena
- Department of Biomedical Sciences, Ohio University, Athens, OH, United States
| | - Timothy D. Law
- Ohio Musculoskeletal and Neurological Institute, Ohio University, Athens, OH, United States
| | - Erin Walsh
- Biological Sciences Department, Ohio University, Athens, OH, United States
| | - Mason C. Campbell
- Biological Sciences Department, Ohio University, Athens, OH, United States
| | - Leslie A Consitt
- Department of Biomedical Sciences, Ohio University, Athens, OH, United States
- Ohio Musculoskeletal and Neurological Institute, Ohio University, Athens, OH, United States
- Diabetes Institute, Ohio University, Athens, OH, United States
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Carlen AE, Hafen MJ, Evans RW, Olsen CD. Using exercise training to improve glycemic control and uncover mechanisms of impaired skeletal muscle in type 1 diabetics. J Physiol 2022; 600:2553-2555. [PMID: 35420167 DOI: 10.1113/jp282964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Austin E Carlen
- Nutrition, Dietetics, and Food Science, Brigham Young University, Provo, UT
| | - Michael J Hafen
- Nutrition, Dietetics, and Food Science, Brigham Young University, Provo, UT
| | - R William Evans
- Nutrition, Dietetics, and Food Science, Brigham Young University, Provo, UT
| | - Christian D Olsen
- Nutrition, Dietetics, and Food Science, Brigham Young University, Provo, UT
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Hawke TJ. Do those with Type 1 Diabetes need more exercise to maintain skeletal muscle health? J Physiol 2022; 600:1281-1282. [PMID: 35167704 DOI: 10.1113/jp282800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Thomas J Hawke
- Dept. of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
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Minnock D, Annibalini G, Valli G, Saltarelli R, Krause M, Barbieri E, De Vito G. Altered muscle mitochondrial, inflammatory and trophic markers and reduced exercise training adaptations in type 1 diabetes. J Physiol 2022; 600:1405-1418. [PMID: 34995365 PMCID: PMC9306774 DOI: 10.1113/jp282433] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 12/21/2021] [Indexed: 11/08/2022] Open
Abstract
KEY POINTS Type 1 diabetes negatively affects skeletal muscle health; however, the effect of structured exercise training on markers of mitochondrial function, inflammation and regeneration is not known. Even though participants with type 1 diabetes and healthy control were comparable for cardiorespiratory fitness (VO2 max) and muscle strength at baseline, molecular markers related to muscle health were decreased in type 1 diabetes. After training, both groups increased the VO2 max and muscle strength, however, a larger improvement was achieved by the control group. The training intervention decreased glucose fluctuations and occurrence of hypoglycaemic events in type 1 diabetes, while signs of mild myopathy found in the muscle of participants with type 1 diabetes only partially improved after training Improving muscle health by specific exercise protocols is of considerable clinical interest in therapeutic strategies for improving type 1 diabetes management and prevent or delay long-term complications. ABSTRACT Growing evidence of impaired skeletal muscle health in people with type 1 diabetes points toward the presence of a mild myopathy in this population. However, this myopathic condition is not jet well characterised and often overlooked, even though it might affect the whole-body glucose homeostasis and the development of comorbidities. This study aims to compare skeletal muscle adaptations and changes in glycaemic control after 12 weeks of combined resistance and aerobic (COMB) training between people with type 1 diabetes and healthy controls, and whether the impaired muscle health in type 1 diabetes can affect the exercise-induced adaptations. The COMB training intervention increased aerobic capacity and muscle strength in both healthy and type 1 diabetes sedentary participants, although these improvements were higher in the control group. Better glucose control, reduced glycaemic fluctuations and fewer hypoglycaemic events were recorded at Post- compared to Pre-intervention in type 1 diabetes. Analysis of muscle biopsies showed an alteration of muscle markers of mitochondrial functions, inflammation, aging and growth/atrophy compared to the control group. These muscular molecular differences were only partially modified by the COMB training and might explain the reduced exercise adaptation observed in type 1 diabetes. In brief, type 1 diabetes impairs many aspects of skeletal muscle health and might affect the exercise-induced adaptations. Defining the magnitude of diabetic myopathy and the effect of exercise, including longer duration of the intervention, will drive the development of strategies to maximize muscle health in the type 1 diabetes population. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Dean Minnock
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Giosuè Annibalini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Giacomo Valli
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - Roberta Saltarelli
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Mauricio Krause
- Department of Physiology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Elena Barbieri
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Giuseppe De Vito
- Department of Biomedical Sciences, University of Padova, Padova, Italy
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