Can moderate exercise reverse blood vessel damage in diabetes?

WHAT THE RESEARCH SAYS

Recent research from the Center for Vascular Biology at the Medical College of Georgia (MCG) shows that angiogenesis, or the ability to form new blood vessels, is also possible in diabetics if they engage in moderate-intensity exercise. This allows more exosomes, submicroscopic packages packed with biologically active cargo, to directly deliver to those cells more of the protein, ATP7A, which can kick-start angiogenesis, according to the report in The FASEB Journal. Now ATP7A levels are reduced in diabetes. Physical exercise, such as running or walking on a treadmill, causes the muscles to contract, which in turn causes the release of exosomes into the blood.

While MCG vascular biologist and cardiologist Tohru Fukai, MD, and co-author vascular biologist, Masuko Ushio-Fukai, MD, are still unsure of the origin of these helpful exosomes, it’s clear that one place they land is to endothelial cells. In both an animal model of type 2 diabetes and a handful of healthy 50-somethings, two weeks of volunteer running on a treadmill for the mice and one cardio session for the humans increased ATP7A levels in exosomes that they are attached. to endothelial cells. At that time, the activity did not significantly affect the weight of the mice, the scientists note, but it increased a marker of endothelial function and factors such as vascular endothelial growth factor that are necessary for angiogenesis.

WHY IS THIS STUDY RELEVANT TO THE INDIANS?

The study findings offer hope for many Indians living with co-morbidities, not just diabetes but also heart conditions. Says Dr. Anoop Misra, president of the CDOC Fortis Diabetes Center: “We get diabetic foot complaints all the time where a patient’s blood vessels are severely affected. In fact, their condition is often aggravated by the allied threats of high blood pressure and cholesterol. So this study is interesting in that for the first time it suggests the possibility of new vessels forming in diabetics whose blood vessels are affected first. Of course, we prescribe walking and moderate exercise as first-line therapy, but this is the first time its benefit has been established clinically.”

Of course, it has a caveat. “This finding needs to be tested in a practical setting. One has to see if the regeneration of blood vessels can significantly help with damage to the heart, kidneys, and eyes. If it can repair diabetic feet, can it have a healing effect on ulcers? For that, we need more studies and more trials in humans in all conditions”, adds Dr. Misra.

HOW SHOULD YOU EXERCISE

According to Harvard Medical School Updates, several studies have shown that exercise lowers HbA1c values ​​in people of different ethnic groups with diabetes who were taking different medications and following a variety of diets. The values ​​improved even when they did not lose any weight.

“Resistance training and aerobic exercise helped reduce insulin resistance in previously sedentary older adults with abdominal obesity at risk for diabetes. Combining the two types of exercise proved to be more beneficial than doing just one. People with diabetes who walked at least two hours a week were less likely to die of heart disease than their sedentary counterparts, and those who exercised three to four hours a week further reduced their risk. Women with diabetes who spent at least four hours a week doing moderate exercise (including walking) or vigorous exercise had a 40 percent lower risk of developing heart disease than those who did not exercise. These benefits persisted even after the researchers adjusted for confounding factors, including BMI, smoking, and other risk factors for heart disease. It is recommended to control blood sugar levels before and after exercise to avoid hypoglycemia. You shouldn’t exercise if your blood sugar is too high (over 250), because it can sometimes raise your blood sugar even higher.