Psychology and exercise: final research highlights from DUKPC – by Faye Riley

This is the final part of our series on DUKPC research highlights. If you haven’t caught the others, find out the latest on treatments targeting the immune system and diabetes subtypes and genetics. This time, I’m covering psychology and exercise.

The psychology of hypos

Psychology and the emotional impact of living with diabetes was a hot topic this year, with one session focusing on hypos.

Hypo treatments

Dr Linda Gonder-Frederick told us about fear, explaining that the average person with Type 1 diabetes will experience 3,500 hypos they can treat themselves and 30-70 severe hypos over 40 years. So it’s little wonder they’re a big worry.

When it comes to what fear of hypos can mean for blood sugar levels, the evidence is mixed. Some research shows fear can have a negative impact on blood sugar control. On the other hand, fear can help to motivate people to get on top of their diabetes management.

It’s not just people with diabetes that can develop fear. It’s also a worry for carers and family members. Dr Gonder-Frederick found partners of people who have frequent hypos report more marital conflict, more sleep disturbances and greater anxiety.

But for some, hypos aren’t their main concern. Researchers asked 96 people with Type 1, who had lots of hypos, for their biggest diabetes worry. Top of the list was high blood glucose and complications. So anxiety about future health could be driving people to risk going hypo. Dr Christel Hendrieckx told us one participant said, “I’d rather be hypo than blind.”

Dr Hendrieckx stressed we need to shift attitudes about hypos and hypers, and help people get the balance right. But there’s a lot of work to do. Scientists need to find the best ways of supporting people with diabetes to manage their thoughts and feelings around hypos.

A work out for your beta cells

There’s been lots of research that’s shown us exercise can help our bodies respond better to insulin. But scientists are only just beginning to explore whether exercise can improve the amount of insulin we make.

DUKPC attendees starting their morning with a 5K run

Researchers in Birmingham and Exeter studied 17 people recently diagnosed with Type 1 diabetes, who were doing plenty of exercise. They matched each person in this group to someone who’d just got Type 1 but wasn’t exercising.

They found people who exercised had a longer ‘honeymoon’ period, when some beta cells are still working and the body is still sensitive to insulin. It lasted on average four times longer in those who exercised (28.1 months compared to 7.5 months). One of the researchers, Dr Parth Narendran, explained that exercise could keep you honeymooning for longer by improving how the body responds to insulin and protecting beta cells.

Professor Décio Eizirik told us more about the protective power of exercise. He found that exercise can increase proteins related to keeping beta cells healthy, and decrease proteins involved in beta cell death. Professor Eizirik says we now need clinical trials with people newly diagnosed with Type 1 diabetes, to see if exercise could delay or protect against beta cell death.

He thinks exercise might be a form of immunotherapy in the future, slowing the progression of Type 1 diabetes. A little insulin goes a long way: keeping precious beta cells kicking for as long as possible could make managing Type 1 easier and keep people healthier for longer.

And exercise is available to everyone, with positive effects on your overall health. So until scientists make the next big step in developing treatments that slow the immune attack, why not get moving? Delve into our advice on exercising with Type 1 here.

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