Can exercise delay the onset of type 1 diabetes?

New research suggests that high levels of exercise can help keep type 1 at bay, writes Diabetes WA educator MARIAN BRENNAN.

Type 1 diabetes is what we call an autoimmune condition, where the body’s immune system attacks its own insulin producing cells – the beta cells. This process continues until there are no beta cells left, meaning the person with type 1 diabetes can no longer produce their own insulin. Interestingly, about 60% of people diagnosed with type 1 diabetes experience a ‘honeymoon’ period, where the body still produces small amounts of insulin because the beta cells partially recover (if only for a short time). During this period, some people find they do not need to inject as much insulin and find it easier to manage blood glucose levels. Some studies have also found that experiencing a honeymoon period is associated with fewer diabetes-related complications affecting the eyes and kidneys. I am sure I don’t need to tell those of you living with type 1 diabetes, but those first few months after being diagnosed can be very stressful. Exercise does have the potential to complicate diabetes management, so your health professional might have recommended you back off the exercise until you get the hang of things. While this advice may be sensible, the topic of exercise is rarely revisited later on. Even more concerning, some health professionals continue to discourage exercise even when their patient has come to grips with managing their diabetes. This is a shame, as the benefits of physical activity and structured exercise are well-established for those living with type 1 diabetes. Exercise

can reduce the risk of cardiovascular disease, improve well-being, reduce insulin requirements, and reduce mortality. Indeed, physical activity is considered an official management strategy for type 1 diabetes. What we didn’t know, until recently, was how soon we should introduce exercise as part of managing diabetes. Although this will still vary between individuals, researchers are now investigating the use of exercise much earlier following a diagnosis. Emerging research suggests that those who are more active at the point of diagnosis and in the months following have much longer honeymoon periods – essentially delaying the onset of type 1 diabetes! A small study out of Birmingham University in the UK showed that the honeymoon period was more than five times longer (on average, 33 months versus six months) in men who undertook high levels of exercise when compared to matched sedentary individuals.

When we think about the abovementioned benefits of experiencing a honeymoon period, it is exciting to see the potential exercise has for extending that honeymoon. It is also perhaps a very important reminder for people living with diabetes and for diabetes health professionals to start the conversation around exercise earlier. Of course, you may not feel ready to tackle exercise, but if you’re up for it, let’s talk! If you would like to speak to our dual qualified accredited exercise physiologist and credentialled diabetes educator, Dr Marian Brennan PhD about starting or increasing your physical activity, visit Perth Physical Activity and Diabetes Institute (www.perthpadi.com).