Item
#6
Exercise
Improves Endothelial Function in Patients with Type 1 Diabetes
Aerobic
exercise training can improve endothelial function.
The
object of the study was to determine whether a persistent improvement
of endothelial function can be achieved by regular physical
training.
The
study included 26 patients with type 1 diabetes of 20 ± 10
years’ duration and no overt angiopathy; 18 patients (42
± 10 years old) participated in a bicycle exercise
training program, and 8 patients with type 1 diabetes (33
± 11 years old) served as control subjects. Vascular
function of conduit arteries was assessed by flow-mediated
and endothelium-independent dilation of the brachial artery
and of resistance vessels by the response of ocular fundus
pulsation amplitudes to intravenous NG-monomethyl-L-arginine
(L-NMMA) at
baseline, after 2 and 4 months of training, and 8 months
after cessation of regular exercise.
The
results showed that training increased peak oxygen uptake (VO2max)
by 13% after 2 months and by 27% after 4 months (P =
0.04). Flow-mediated dilation (FMD) of the brachial artery
increased from 6.5 ± 1.1 to 9.8 ± 1.1% (P = 0.04)
by training. L-NMMA
administration decreased fundus pulsation amplitude (FPA) by
9.1 ± 0.9% before training and by 13.4 ± 1.5% after 4
months of training (P = 0.02). VO2max,
FMD, and FPA were unchanged in the control group. Vascular
effects from training were abrogated 8 months after
cessation of exercise.
The
study demonstrates that aerobic exercise training can
improve endothelial function in different vascular beds in
patients with long-standing type 1 diabetes, who are at
considerable risk for diabetic angiopathy. However, the beneficial
effect on vascular function is not maintained in the absence
of exercise Diabetes
Care 25:1795-1801,
2002
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DID
YOU KNOW:
The
UKPDS found that in patients with type 2 diabetes, glycemic control
will eventually deteriorate due to pancreatic beta-cell failure. In
time, these patients will find that using multiple oral agents will
not allow them to maintain the targeted hemoglobin A1c level of less
than 7%. Currently, only 40% of patients with type 2 diabetes use
insulin therapy. A greater number could certainly benefit from
intensive insulin management to ameliorate symptoms and decrease the
frequency and severity of long-term diabetes complications.
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