Exercise Training Can Modify The Natural History Of Diabetic Peripheral Neuropathy

Abstract

Background Diabetes is the most important cause of diabetic peripheral neuropathy (DPN). No definitive treatment for DPN has been established and very few data on the role of exercise training on DPN have been reported. Aim of the study We sought to examine the effects of long-term exercise training on the development of DPN in both type 1 and type 2 diabetic patients Subjects & Methods 78 consecutive diabetic patients without signs and symptoms of peripheral DPN were enrolled, randomized and subdivided in two groups: 31 diabetic subjects (15 f, 16 m; 49±15.5 yrs; BMI 27.9±4.7), who performed a prescribed and supervised 4 hr/week brisk walking on a treadmill at 50 to 85% of the heart rate reserve (exercise group: EXE); and 47 diabetic subjects (24 f, 23 m; 52.9±13.4 yrs; BMI 30.9±8.4) with a sedentary lifestyle and no physical activity during the study represented the control group (CON). Vibration Perception Threshold (VPT), nerve distal latency (DL), nerve conduction velocity (NCV) and nerve action potential amplitude (NAPA) in the lower limbs were measured. Results We found significant differences on Δ (delta) in NCV for both peroneal and sural motor nerve between EXE and CON groups during the study period (p < 0.001, for both). The percentage of diabetic patients that developed motor neuropathy and sensory neuropathy during the 4 years of the study was significantly higher in CON than the EXE group (17%.0 vs 0.0%, p < 0.05 and 29.8% vs. 6.45%, p < 0.05, respectively). Also, the percentage of diabetic patients who developed increased VPT (>25 V) during the study was significantly higher in CON than EXE group (21.3% vs. 12.9%, p < 0.05). Change on Hallux VPT from baseline to the end of the study was significantly different between EXE and CON groups (p < 0.05); no significant change in Malleolus VPT between the two groups occurred. Conclusions This study suggests for the first time that long-term acrobic exercise training can prevent the onset or modify the natural history of DPN.