Children who have a first-degree relative with type 1 or gestational diabetes can also improve their insulin sensitivity through exercise, meaning that exercise is an effective preventive strategy not only for children at risk of developing type 2 diabetes. This is the conclusion of researchers from the Helmholtz Zentrum München, a partner in the German Center for Diabetes Research, who published their findings in the journal Diabetic Medicine.

Children and adolescents who have a first-degree relative with type 1 diabetes or gestational diabetes are at increased risk of becoming overweight or obese in the course of life, thus making them more likely to develop insulin resistance, a precursor of type 2 diabetes. “However, until now it was unclear whether this risk can be reduced by physical exercise, as is the case with type 2 diabetes,” says Dr. Andreas Beyerlein, explaining the focus of the ongoing research. A statistician and epidemiologist at Helmholtz Zentrum München, he headed the study together with Prof. Dr. med. Anette-Gabriele Ziegler, Director of the Institute of Diabetes Research (IDF) and Head of the Diabetes Research Group.

To shed light on this issue, the authors examined the data of 234 children with a median age of ten years. All of the subjects had at least one first-degree relative with either type 1 or gestational diabetes. The scientists collected metabolic data, measured inflammatory markers (cytokines) in the blood and recorded information on the children's physical activity. They also carried out an oral glucose tolerance test. In this test, blood sugar levels are measured after fasting as well as two hours after drinking 75 grams of glucose or a better tolerated mixture of short-chain carbohydrates dissolved in water. The test provided information on how well the children's metabolic system deals with the large amount of sugar supplied. *

Better to put the smartphone aside from time to time
“Our results indicate that moderate to vigorous physical activity is associated with better test results in children who are at risk,” says lead author Kathrin Ungethüm (IDF), who completed her master's thesis in epidemiology using these data. “The more active children not only metabolized the sugar more rapidly but also had lower insulin and C­ peptide levels.” The researchers see it as a good sign that the children were able to metabolize the sugar with the available hormone. If an increase in insulin and C-peptide, which is simultaneously released, had been observed, this would have suggested that the children's metabolic system was overwhelmed and was attempting to compensate by increasing the levels of insulin.

Above all, the authors were able to show that the insulin sensitivity was significantly improved by physical activity. This could indirectly indicate that exercise may also be beneficial as a treatment for type 1 diabetes, thus reducing the strain on insulin­producing beta cells. By contrast, no correlations were found for the body mass index, blood pressure or inflammatory markers.

“Our results show that physical activity also has a very positive effect on the metabolism of children with a genetic predisposition for type 1 diabetes,” says study leader Anette­Gabriele Ziegler. “For this and many other reasons, it may very well be worthwhile to put aside the smartphone from time to time and go outside for to playing together.”

Original publication:
Ungethüm, K. et al. (2018): Physical Activity is Associated with Lower Insulin and C-peptide during Glucose 1 Challenge in Children and Adolescents with Family Background of Diabetes. Diabetic Medicine, DOI: 10.1111/dme.13819

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As German Research Center for Environmental Health, Helmholtz Zentrum München pursues the goal of developing personalized medical approaches for the prevention and therapy of major common diseases such as diabetes mellitus, allergies and lung diseases. To achieve this, it investigates the interaction of genetics, environmental factors and lifestyle. The Helmholtz Zentrum München has about 2,300 staff members and is headquartered in Neuherberg in the north of Munich. Helmholtz Zentrum München is a member of the Helmholtz Association, a community of 18 scientific-technical and medical-biological research centers with a total of about 37,000 staff members.

The Institute of Diabetes Research (IDF) focuses on the understanding of the natural history of type 1 diabetes, on the identification of mechanisms and predictive markers of the disease, and the translation of findings into trials to prevent type 1 diabetes in man. In particular, the institute’s aim is to develop an immune tolerance using antigen-based therapy. The IDF conducts long-term studies to examine the link between genes, environmental factors and the immune system for the pathogenesis of type 1 diabetes. Findings of the BABYDIAB study, which was established in 1989 as the world’s first prospective birth cohort study, identified the first two years of life as being most susceptible for the initiation of type 1 diabetes associated autoimmunity. The Fr1da study is the first population-based approach for the early diagnosis type 1 diabetes associated autoimmunity in childhood. The IDF is part of the Helmholtz Diabetes Center (HDC).

The German Center for Diabetes Research (DZD) is a national association that brings together experts in the field of diabetes research and combines basic research, translational research, epidemiology and clinical applications. The aim is to develop novel strategies for personalized prevention and treatment of diabetes. Members are Helmholtz Zentrum München – German Research Center for Environmental Health, the German Diabetes Center in Düsseldorf, the German Institute of Human Nutrition in Potsdam-Rehbrücke, the Paul Langerhans Institute Dresden of the Helmholtz Zentrum München at the University Medical Center Carl Gustav Carus of the TU Dresden and the Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Zentrum München at the Eberhard-Karls-University of Tuebingen together with associated partners at the Universities in Heidelberg, Cologne, Leipzig, Lübeck and Munich.