The benefits of physical exercise for the health of the pancreatic β‐cell: a review of the evidence

Abstract

Physical exercise is a core therapy for type 1 and type 2 diabetes. Whilst the benefits of exercise for different physiological systems are recognised, the effect of exercise specifically on the pancreatic -cell is not well described. Here we review the effects of physical exercise on -cell health.We show that exercise improves -cell mass and function. The improved function manifests primarily through the increased insulin content of the -cell and its increased ability to secrete insulin in response to a glucose stimulus. We review the evidence relating to glucose sensing, insulin signalling, -cell proliferation and -cell apoptosis in humans and animal models with acute exercise and following exercise training programmes. Some of the mechanisms through which these benefits manifest are discussed. K E Y W O R D S

The Impact of Physical Activity on Glycemic Variability Assessed by Continuous Glucose Monitoring in Patients With Type 2 Diabetes Mellitus: A Systematic Review

“…However, due to the short duration of the majority of the trials, the differential effects of exercise according to remaining beta-cell function or diabetes duration may not appear. If the mechanisms of improved beta-cell function involve beta-cell rest due to an increased peripheral insulin sensitivity and thus reduced glucotoxicity or decreased low-grade inflammation ( 43 ), the trial duration should be prolonged (>4 weeks) until such effects would become apparent ( 44 ). Literature suggests that long-term adaptations from regular exercise improve glucose metabolism through increased glucose uptake capacity but may decrease the temporary insulin sensitizing effect after an acute bout of exercise ( 45 ).…”

Exercise and metabolic health: beyond skeletal muscle

“…Insulin secretion is primarily adjusted according to the amount of glucose taken up by beta cells. Insulin secretion during a glucose challenge is dramatically altered by exercise undertaken during the previous days and hours in both healthy individuals and in those with insulin resistance and type 2 diabetes [73]. Exercise cessation drives up insulin secretion, while one bout of exercise can lower insulin secretion, showing that insulin secretion is tightly regulated by exercise-driven pathways [74].…”

Skeletal muscle microvascular insulin resistance in type 2 diabetes is not improved by eight weeks of regular walking

“…We postulate that protein glycosylation was decreased secondary to increased metabolic activity and glucose turnover caused by physical activity. It is also possible that a decrease in HbA1c with walking was related to improvements in pancreatic beta-cell function (24). Importantly, it has been well documented that each 1% reduction in HbA1c is associated with a 14% reduction of myocardial infarction and a 21% decrease of risk of death related to diabetes (69a), illustrating the potentially impactful nature of this finding on T2D health.…”