Effects of non-supervised low intensity aerobic excise training on the microvascular endothelial function of patients with type 1 diabetes: a non-pharmacological interventional study

Roger de Moraes, Diogo Van Bavel, Marília de Brito Gomes, Eduardo Tibiriçá, Roger de Moraes, Diogo Van Bavel, Marília de Brito Gomes, Eduardo Tibiriçá

Abstract

Background: The aim of the present study was to evaluate changes in microvascular density and reactivity in patients with type 1 diabetes (T1D) resulting from low intensity chronic exercise training.

Methods: This study included 22 (34 ± 7 ears) consecutive outpatients with T1D and disease duration > 6 years. We used intravital video-microscopy to measure basal skin capillary density and capillary recruitment using post-occlusive reactive hyperemia (PORH) in the dorsum of the fingers. Endothelium-dependent and -independent vasodilation of the skin microcirculation was evaluated in the forearm with a laser Doppler flow monitoring (LDF) system in combination with acetylcholine and sodium nitroprusside iontophoresis, PORH and local thermal hyperemia.

Results: The basal mean capillary density (MCD) after exercise training was significantly higher than before exercise (134 ± 25 vs. 119 ± 19 capillaries/mm(2), respectively; P = 0.0013). MCD during PORH was also higher after exercise (140 ± 26 vs. 121 ± 24 capillaries/mm(2), respectively; P < 0.0001). Endothelium-dependent capillary recruitment during PORH was also significantly higher after exercise (140 ± 26 vs. 134 ± 25 capillaries/mm(2), respectively; P < 0.0012). There were no significant changes in skin microvascular reactivity after exercise as investigated using LDF.

Conclusions: Our results showed that low intensity aerobic exercise, performed four times per week for 12 weeks by patients with T1D, induces significant increases in microvascular density and endothelial-dependent capillary reactivity.

Trial registration: ClinicalTrials.gov NCT02441504. Registered 7 May 2015.

Figures

Fig. 1
Fig. 1
Functional capillary density at baseline (BASAL) and during post-occlusive reactive hyperemia (PORH) before (PRE) and after (POST) exercise training in patients with type 1 diabetes (n = 22). The values represent the means ± SEM. Paired or unpaired Student’s two-tailed t-tests were used when appropriate
Fig. 2
Fig. 2
Microcirculatory parameters of patients with type 1 diabetes before and after exercise training. The maximum microvascular blood flow, expressed in arbitrary perfusion units (PU), and the area under the curve, expressed in PU/s, resulted from microvascular stimulation with acetylcholine (a, ACH), sodium nitroprusside (b, SNP), post-occlusive reactive hyperemia (c, PORH) and thermal hyperemia (d, TH)

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