Epigenetics and Exercise in Type 1 Diabetes
Research type
Research Study
Full title
DNA methylation in cardiovascular disease and advanced glycation end-product related genes: Effects in type 1 diabetes and exercise
IRAS ID
266248
Contact name
Gareth Davison
Contact email
Sponsor organisation
Ulster University
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
Research Summary
Cardiovascular disease (CVD) is one of the main complications of Type 1 Diabetes Mellitus (T1DM) due to poor blood glucose control. Excess sugars (hyperglycaemic state) within the bloodstream bind to proteins and fats that circulate the body forming new biological molecules that can be dangerous to health, known as advanced glycation end-products (AGE’s). Build-up of AGEs disrupts normal cell functions leading to development of CVD. Poor glucose control and a sedentary lifestyle are involved in the development of AGEs and CVD.
Sixty per cent of patients with T1DM do not participate in regular exercise failing to reach the recommended minimum physical activity of thirty minutes of moderate exercise a day due to a number of barriers that can be both physical and mental.Fear of having a hypoglycaemic incident is one of the main barriers for T1DM patients. Patients tend to over compensate by eating more carbohydrate or reducing bolus/ quick acting insulin dose, putting them at risk of hyperglycaemia and thus off setting any benefits gained from the exercise.
Patients that participate in regular exercise, are more like to require less insulin, have a better HbA1c as well as reduced risk of ketoacidosis.
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DNA methylation a form of epigenetics, involving the process of adding a molecule known as a methyl group to DNA. Changing the expression of the gene without changing the sequence of DNA. When a methyl group is attached to the DNA sequence, gene expression is inhibited. If a methyl group is removed, the gene can be expressed.
Regulation of gene expression is an essential process that impacts the expression of each tissue within the human body. Exercise induced epigenetics modifications may reduce changes to cell functions that have been caused by hyperglycaemia and AGEs for example in cardiovascular related disease, for example in cardiovascular related diseases. Studies within the healthy sedentary population have demonstrated that exercise can modify methylation of DNA. This study will explore if changes in DNA methylation will enhance cardiovascular protection from exercise and will be compared to a control group.Summary of Results
This study went through several different amendments due to the covid-19 pandemic. Due to further time restraints and lack of funding available the epigenetic analysis of the study was not completed. Therefore, this study investigated the effects of an education-led intervention to improve physical activity and sedentary behaviour in participants with type 1 diabetes mellitus compared to their healthy counterparts as we emerged from the covid-19 pandemic.
Results from the study have indicated that physical activity was improved in the type 1 diabetes group, and an overall decline in the control group was observed. Significant improvements (p<0.05) in moderate physical activity were found in the type 1 diabetes group as well as changes to sedentary behaviour; by breaking up sedentary behaviour into smaller time bouts.
A more in dept analysis looked at how participants changed their moderate to vigorous physical activity (MVPA) from pre to post. It was noticed that initially the control group were more active than the diabetes group. The type 1 diabetes group completed longer bouts of MVPA within the post time point bringing them more in line with physical activity completed by the control group.
The time of day in which participants carried out their physical activity was also monitored. Overall, there was an increase in moderate activity within the afternoon and evening time for the diabetes group, alongside an increase in step count in the morning period.
Physical fragmentation was also investigated - it examines the percentage of time that the participants fragment their activity. The lower the percentage, the less fragmented the activity, which is associated with health outcomes. The diabetes group observed a decrease in their fragmentation with fragmentation increasing in the control group.
Minor changes to diabetes management where also noted by analysing data from flash/continuous glucose monitors. An increase in hypoglycaemic events were noted in the afternoon at the post time point; but no differences in the amount experienced in the evening time between time points. Time in range for the diabetes group did not see any significant changes, demonstrating better overall control of diabetes management. Self-reporting questionnaires recorded throughout the study further backed up the evidence of an increase in physical activity for the diabetes group and an overall decline for the control group.
Significant changes to total (p=0.043) and LDL cholesterol (p=0.016), as well as HbA1c (p=<0.01) and plasma glucose (p=0.011) were also detected from pre to post time points.
Overall the intervention was successful at improving physical activity in participants with type 1 diabetes as we emerged from the covid-19 pandemic.REC name
West of Scotland REC 1
REC reference
20/WS/0047
Date of REC Opinion
13 May 2020
REC opinion
Further Information Favourable Opinion