Effect of a supervised program of physical exercise on the glycemic variability and oxidative stress in patients with unstable type 1 diabetes mellitus

Abstract

Complications, acute and chronic, patients with diabetes mellitus type 1 (DM1) are the reflection of variability in glycemic control caused by loss of blood glucose levels in consequence of the absence or insufficiency in insulin production by pancreatic beta cells. Thus, insulin therapy in these patients is fully able to delay disease progression macro and microvascular changes, however, the expense of an increased risk of severe hypoglycemia. It has also suggested that oxidative stress is related to the pathogenesis of complications of DM1, on the other hand, studies has shown that regular physical activity plays a beneficial role, both in terms of decreasing the risk of cardiovascular events, and in improving glycemic control. Main objective: To evaluate the effect of a program of supervised physical exercise in patients with unstable type 1 diabetes and its potential in reducing glycemic variability of this population. Secondary Objective: Study the impact of supervised physical exercise on oxidative stress in type 1 diabetic individuals unstable. Materials and methods: It will be included 30 volunteers with type 1 diabetes in both genres between 31 and 45 years. Subjects will be randomized in two groups (A and B) into acontrolled crossover trial with no need of a control group of nondiabetics volunteers. The group A will receive the intervention for three months of supervised aerobic and anaerobic physical activity. Thereafter, they will remain for four weeks in "wash out" and then will be evaluated on their activities of daily livingalso for a period of three months. The volunteers randomized to group B will start the study maintaining their activities of daily living for three months. Right after, they will start a supervised exercise program with the same characteristics as those performed by group A. Each individual will perform aerobic activityin the cardiac frequency of the ventilatory threshold I obtained in cardiopulmonary exercise test and monitored by frequency counter during training. The resistance exercises will be done according to the criteria of the American College of Sports Medicine. The glycemic variability will be evaluated through the Continuous Glucose Monitoring (CGMS) for a period of 72 hours in five different times during the protocol. For the study of body composition will be held the body mass index and whole body plethysmography via the BOD POD (body composition system, Life Measurement Instruments, C oncord, C A). The measures of the oxidative stress in peripheral dosage of glutathione (reductase and oxidase) and thiobarbituric acid reactive substances will also be analised (TBARS) (AU)