Good personal habit of exercise may protect against development of diabetic polyneuropathy in type 1 diabetes

The researchers found that diabetic polyneuropathy (DPN) is less present in patients with type 1 diabetes (T1D) with a good personal habit of physical activity (PA) and good metabolic control. They suggest moderate-to-vigorous PA of at least 600 metabolic equivalent of task (MET) minutes/week might be a protective factor against DPN.

"The study of 90 adult patients with type 1 diabetes suggests patients achieving 600 MET minutes or more per week saw a significant reduction in risk of diabetic neuropathy compared to their counterparts with reduced fitness levels," Simona Zaccaria, University of Rome Tor Vergata, Rome, Italy, and colleagues reported.

While the beneficial effects of physical activity on clinical diabetic neuropathy in type 2 diabetes mellitus (T2DM) are well known, there is less clarity on the benefits of PA in type 1 diabetes. Therefore Dr. Zaccaria and colleagues aimed to assess whether a personal attitude to physical activity may impact the appearance of diabetic polyneuropathy patients with well-controlled type 1 diabetes mellitus.

A total of ninety patients attending the diabetes technology outpatient clinic were enrolled in the study. According to the Toronto Consensus diagnostic criteria, DPN was investigated. Physical activity was assessed using the International Physical Activity Questionnaire.

Based on the study, the researchers reported the following findings:

• Physical activity was low in 21.1%, moderate in 42.2% and high in 36.7% of patients.
• According to Toronto criteria, two categories were defined: the first one with DPN absent or possible (63.3%) and the second one with DPN certain or probable (36.7%).
• The χ2-test of the PA groups and the DPN categories showed a statistically significant difference, with less neuropathy in patients belonging to the group of moderate/high PA.
• Exposure to a minimum of 600 MET minutes/week was a protective factor against the onset of DPN (odd ratio 0.221).

"The study suggests that a personal attitude towards physical activity may prevent or delay DPN onset, and a moderate exercise of at least 600 MET minutes/week may protect against the DPN onset and that the main risk factors for CV diseases are the same for polyneuropathy development," the article stated.

"There will be a necessity for further studies to confirm these data with a larger sample and a longitudinal aspect," the researchers wrote.

"To date, patients with type 1 diabetes should be educated to take up physical activity early, and insulin therapy, as part of their treatment plan and to prevent complications that may be associated with a disease's long duration," they suggested.

Reference:

Zaccaria, S., Di Perna, P., Giurato, L., Pecchioli, C., Sperti, P., Arciprete, F., Del Grande, A., Nardone, I., Wolde Sellasie, S., Iani, C., & Uccioli, L. (2022). Diabetic Polyneuropathy and Physical Activity in Type 1 Diabetes Mellitus: A Cross-Sectional Study. Journal of Clinical Medicine, 12(20), 6597. https://doi.org/10.3390/jcm12206597