Symposium: Strategies for β cell preservation in autoimmune diabetes

Abstract

In patients with T1D, the insulin producing beta cells in the pancreas are damaged and stop making insulin. Whilst patients must start taking insulin injections at diagnosis, not all these cells have been destroyed at this time. The remaining beta cells are gradually destroyed over a number of years after the patient is diagnosed. Studies tell us that protecting these remaining beta cells helps control sugar levels, reduces the risk of low sugar (hypoglycaemia) and prevents the development of diabetes complications such as blindness and heart attacks. There is now evidence that exercise protects beta cells in healthy people & patients with other forms of diabetes. We wanted to do a pilot study to see if this is also true for adult patients with T1D.

Our project was divided into 2 stages. First we wanted to understand the barriers to exercise in patients with new onset T1D. Secondly we wanted to ask patients with new onset T1D to take up regular exercise for a year and measure a number of factors that we needed to know to design a proper study to test whether exercise preserves beta cell function.

The findings from the first stage of this study highlighted a number of significant barriers to exercise in patients with T1D. In particular patients worried about the risk of hypoglycaemia and the effects of exercise on glucose stability for the hours and days after exercise.

For the second stage of the study, five hundred adult patients with newly diagnosed type 1 diabetes across England were screened and 58 patients were eventually recruited. From this we can say that 15 of every 100 patients newly diagnosed with T1D who were approached to enter the study actually did so. We saw that exercise levels increased in those patients that entered the exercise arm of the study. This increase was associated with a reduction in insulin requirements and improvement in insulin sensitivity. In this talk I will explain how the exercise intervention affected insulin secretion by the beta cell and how it can be incoorporated into the management of the newly diagnosed adult with type 1 diabetes.