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Exercise may prolong early partial remission of type 1 diabetes
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Among men with new-onset type 1 diabetes, exercise can play a role in extending the “honeymoon” period of partial remission after diagnosis, according to findings published in Diabetic Medicine.
“Shortly after diagnosis, 60% of adults with type 1 diabetes experience a period of partial remission, or ‘honeymoon’ period, characterized by low insulin requirement and good glycemic control,” Madhurima Chetan, MD, of the College of Medical and Dental Sciences, University of Birmingham, U.K., and colleagues wrote in the study’s background. “The honeymoon period is attributed to two factors: partial recovery of beta-cell function and normalization of insulin sensitivity. Both decline with type 1 diabetes, bringing the honeymoon period to a natural close.”
In a small retrospective study, researchers identified 16 men with type 1 diabetes who were treated at one of three U.K. diabetes clinics (cases). Participants reported beginning substantial physical activity at the time of diabetes diagnosis and continuing with this program through follow-up. Two age-, sex- and BMI-matched controls with type 1 diabetes were selected for each participant; control participants were identified within the same clinic population but reported low levels of physical activity.
The researchers analyzed data on type and duration of exercise, daily insulin requirement, HbA1c and weight. Bolus insulin doses were not available in all cases, so researchers calculated daily insulin requirement as twice the basal insulin dose. The most recent clinic visit at which insulin dose-adjusted HbA1c (calculated as HbA1c + [4 x insulin dose]) was 9 or lower was defined as the honeymoon period duration.
The researchers used the Kruskal-Wallis test to compare age, BMI and duration of follow-up.
Comparable age, BMI, follow-up duration and antibody status were seen between the two groups. At initial presentation, control group participants had significantly more ketoacidosis vs. cases, according to researchers. There was an estimated median honeymoon period of 33 months (95% CI, 24.9-41.1) in cases vs. 6 months (95% CI, 2.3-9.7) in controls (log-rank P < .0001). In an analysis of an antibody-positive subgroup and a non-ketoacidosis subgroup, this significant disparity was sustained. The researchers found that men who perform substantial exercise have a type 1 diabetes honeymoon period that is more than five times longer than that of sedentary men.
“This is the first study to examine effect of physical exercise on the honeymoon period. Our data suggest an important role for exercise in new-onset type 1 diabetes,” the researchers wrote. “There is now a need for a formal, randomized controlled trial to investigate whether exercise prolongs the honeymoon period and to explore the underlying mechanisms.” – by Jennifer Byrne
Disclosures: The authors report no relevant disclosures.
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