BY JOSEPH GUSTAITIS | MARCH 24, 2023
One of the difficulties of diabetes is that it causes the progressive loss of beta cells in the pancreas. Beta cells create, store, and release insulin, and insulin controls the amount of glucose, or sugar, in the blood. Without enough beta cells, blood sugar can get out of control.
Beta cells have been extensively studied, but researchers have yet to find a medication that will prevent beta cell loss in people with diabetes. Now, however, researchers in Belgium have released a study that might point to a way of protecting these crucial cells — exercise. The researchers, who were from the Université Libre de Bruxelles in Brussels, published their paper in the European medical journal Diabetologia.
The authors noted that animal research has suggested that exercise might boost pancreatic beta cells and explained they had previously done a study on eight healthy young men who underwent eight-week exercise training, which led the researchers to report that it had beneficial effects on inflammation-promoting cytokines, or proteins that affect the functioning of various body cells. This earlier study was limited because the number of participants was small, they were all male, and only one type of training was used. In the new study the researchers used a larger group of subjects of both sexes and a wider range of exercise protocols.
The researchers recruited 46 healthy young non-obese subjects, 26 women and 20 men, and organized them into two mixed-gender groups of equal size. Each participant was randomly assigned to different exercise regimens, which included stationary bike high-intensity interval training (HIIT), adapted sprint interval training (aSIT), and vigorous-intensity continuous training (VICT) or high-intensity functional training performed at home (HIFT) three times a week for eight weeks. Five additional volunteers were not assigned to any of the exercise regimens but were asked to carry on their normal physical activities. These participants served as a control group.
Exercise found to protect beta cells
After the test period was over, the researchers reported that the exercise training was, to use their word, “effective.” The researchers rated what’s known as VO2 max, or maximal oxygen uptake, a basic measure of endurance that ascertains the maximum amount of oxygen a person can utilize during exercise, and found that it improved with all exercise protocols. The authors also observed “significant exercise-mediated beta cell protection … at 4 and 8 weeks of training.” That is, they measured cell death (a process what’s known as apoptosis) and reported a 29% to 32% decrease in women and a 27% to 40% decrease in men. Taking all 46 participants together, there was a 28% to 35% decrease in apoptosis at four and eight weeks. The researchers then sought to find out if the protective effects of exercise lasted after the subjects stopped the exercise program. They collected serum from 13 of the participants two months later and, to their surprise, the protective effect was still there.
Because their study had rated young, non-obese, and non-diabetic individuals, the researchers decided to see if the benefits could be replicated in older overweight patients with type 1 or type 2 diabetes and lower VO2 values. After these participants underwent twelve weeks of aerobic and strength training protocols, the researchers reported that they also had improved VO2 values and greater beta cell protection.
In sum, the authors concluded that exercise has a beneficial effect on the survival of pancreatic beta cells that are exposed to what diabetes experts call endoplasmic reticulum (ER) stress — a condition that we now know contributes to beta cell loss and insulin resistance — and that all the tested forms of exercise have this effect. This research, they said, “uncovers the unexpected potential to preserve beta cell health by exercise training, opening a new avenue to prevent or slow diabetes progression.”
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