Can Resistance Exercise Be a Tool for Healthy Aging in Post-Menopausal Women with Type 1 Diabetes?

Abstract

Due to improvements in diabetes care, people with type 1 diabetes (T1D) are living longer. Studies show that post-menopausal T1D women have a substantially elevated cardiovascular risk compared to those without T1D. As T1D may also accelerate age-related bone and muscle loss, the risk of frailty may be considerable for T1D women. Exercise and physical activity may be optimal preventative therapies to maintain health and prevent complications in this population: They are associated with improvements in, or maintenance of, cardiovascular health, bone mineral density, and muscle mass in older adults. Resistance exercise, in particular, may provide important protection against age-related frailty, due to its specific effects on bone and muscle. Fear of hypoglycemia can be a barrier to exercise in those with T1D, and resistance exercise may cause less hypoglycemia than aerobic exercise. There are currently no exercise studies involving older, post-menopausal women with T1D. As such, it is unknown whether current guidelines for insulin adjustment/carbohydrate intake for activity are appropriate for this population. This review focuses on existing knowledge about exercise in older adults and considers potential future directions around resistance exercise as a therapeutic intervention for post-menopausal T1D women.

Type 1 Diabetes and the Menstrual Cycle: Where/How Does Exercise Fit in?

“…The occurrence and fear of hypoglycemia is a significant barrier to exercise for those with T1D [88], especially for females with T1D who tend to consume less carbohydrates than T1D males to prevent activity-related hypoglycemia [89]. This fear may partly explain why females with T1D are less active than their male counterparts [89,90] despite the many health benefits of exercise and physical activity for this population [91].…”

“…The occurrence and fear of hypoglycemia is a significant barrier to exercise for those with T1D [88], especially for females with T1D who tend to consume less carbohydrates than T1D males to prevent activity-related hypoglycemia [89]. This fear may partly explain why females with T1D are less active than their male counterparts [89,90] despite the many health benefits of exercise and physical activity for this population [91]. It is therefore essential that the effects of the menstrual cycle on blood glucose management be assessed further during both rest and exercise in those with T1D in order to alleviate such fear and its associated negative consequences.…”