Increase physical activity to reduce risk for diabetic neuropathy in type 1 diabetes
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Adults with type 1 diabetes for 50 years or more are less likely to have distal symmetric polyneuropathy if they performed at least 150 minutes of physical activity weekly, according to study data.
“These findings provide strong support to clinicians discussing physical activity with their patients as a strategy to reduce the risk of diabetes complications,” Evan Lewis, PhD, a postdoctoral researcher at the Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, in Toronto, told Healio. “Our findings showed that higher self-reported physical activity lowered the incidence of neuropathy by 12% in individuals with long-standing type 1 diabetes. There is potential that habitual physical activity earlier in the natural history of diabetes could have a more protective effect for nerves, from blood sugar control and support for the health of nerves.”
Lewis and colleagues analyzed findings from phase 2 of the Canadian Study of Longevity in Type 1 Diabetes. The study cohort included 75 adults with a type 1 diabetes duration of at least 50 years (55% women; mean age, 66 years). Participants underwent neurologic testing, including a nerve conduction study, and an assessment of the peroneal and sural nerves. The Lifetime Physical Activity Questionnaire was conducted to assess leisure and household physical activities per week.
The findings were published in the Journal of Diabetes and Its Complications.
Of the study cohort, 89% had distal symmetric polyneuropathy, 11% had stage 3 chronic kidney disease and 20% had cardiovascular disease. Participants engaged in a mean of 156 minutes of physical activity per week, with 47% meeting clinical practice guideline recommendations of 150 minutes per week and 37% reporting at least 210 minutes of weekly physical activity.
“We were surprised to see the level of activity in our study group,” Lewis said. “This was a pleasant surprise that almost half of study participants were meeting or exceeding the recommended 150 minutes per week.”
Adults with distal symmetric polyneuropathy performed less physical activity per week compared with those without the condition (141 minutes vs. 258 minutes; P = .015). The prevalence of distal symmetric polyneuropathy was 83% in those who performed more than 150 minutes of physical activity per week compared with 95% in those who reported less physical activity (P = .015). Increased distal symmetric polyneuropathy pain was associated with progressively less physical activity (P for trend = .015).
In correlation analysis, more physical activity was associated with better peroneal and sural amplitude, conduction velocity and peroneal F-wave latency. Each 30 minutes of physical activity resulted in a 0.09 mV higher peroneal amplitude (P = .032) and 0.048 millisecond lower peroneal F-wave latency (P = .022), markers for improved nerve function. Physical activity level was not associated with cardiac autonomic neuropathy.
“This study provides strong rationale for studying the effect of exercise prescription in a clinical setting,” Lewis said. “We are also interested in further investigating the neuroprotective role of exercise and if these benefits are limb-specific or systemic.”
For more information:
Evan Lewis, PhD, can be reached at evan470@icloud.com.
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