What if somebody told you that moderate exercises could help you reverse your diabetic foot, a condition when high blood sugar damages the nerves and blood vessels in the feet, making you numb or tingle at the edges? Now we have evidence that exercises can actually activate a natural system we have to grow new blood vessels when existing ones are ravaged by this disease.
WHAT DOES RESEARCH SAY
Recent research by the Vascular Biology Center at the Medical College of Georgia (MCG) shows that angiogenesis, or the ability to form new blood vessels, is possible in diabetics too if they do a moderate intensity exercise. This enables more exosomes, submicroscopic packages filled with biologically active cargo, to deliver directly to those cells more of the protein, ATP7A, which can set angiogenesis in motion, the report in The FASEB Journal said. Now ATP7A levels get reduced in diabetes. Physical exercise, like running or walking on a treadmill, prompts muscles to contract which in turn prompts release of exosomes into the blood.
While MCG vascular biologist and cardiologist, Dr Tohru Fukai, and co-author vascular biologist Dr Masuko Ushio-Fukai, are not yet certain of the origin of these helpful exosomes, it’s clear that one place they deliver is to endothelial cells. In both an animal model of Type 2 diabetes and a handful of healthy 50-something-year-olds, two weeks of volunteer running on a wheel for the mice and one cardio session for the humans increased levels of ATP7A in the exosomes that are attached to endothelial cells. At that point, the activity did not significantly impact the weight of the mice, the scientists note, but it did increase a marker of endothelial function and factors like vascular endothelial growth factor that are needed for angiogenesis.
WHY IS THIS STUDY RELEVANT FOR INDIANS
The study findings hold out hope for a lot of Indians living with co-morbidities, not just diabetes but also cardiac conditions. Says Dr Anoop Misra, Chairman, Fortis CDOC Center for Diabetes, “We get complaints of diabetic foot all the time where a patient’s blood vessels are affected badly. In fact, their condition is often aggravated by allied threats of hypertension and cholesterol. So this study is interesting in the sense that for the first time it hints at the possibility of new vessels being formed in diabetics whose blood vessels are affected the first. Of course, we do prescribe walking and moderate exercises as frontline therapy, but this is the first time that their benefit has been established in clinical terms.”
Of course, he has a caveat. “This finding has to be proven in a practical scenario. One has to see whether the regrowth of blood vessels can significantly help with damage to heart, kidney and eyes. If it can repair diabetic feet, can it have a healing effect on ulcers? For that we need further studies and more human trials in every condition,” Dr Misra adds.
HOW SHOULD YOU EXERCISE
According to the Harvard medical school updates, several studies have shown that exercise lowered HbA1c values in people across different ethnic groups with diabetes who were taking different medications and following a variety of diets. The values improved even when they didn’t lose any weight.
“Resistance training and aerobic exercise both helped to lower insulin resistance in previously sedentary older adults with abdominal obesity at risk for diabetes. Combining the two types of exercise proved more beneficial than doing either one alone. People with diabetes who walked at least two hours a week were less likely to die of heart disease than their sedentary counterparts, and those who exercised three to four hours a week cut their risk even more. Women with diabetes who spent at least four hours a week doing moderate exercise (including walking) or vigorous exercise had a 40 per cent lower risk of developing heart disease than those who didn’t exercise. These benefits persisted even after researchers adjusted for confounding factors, including BMI, smoking, and other heart disease risk factors,” says its journal. It is advised that one checks one’s blood sugar levels before and after exercise to avoid hypoglycemia. One should not exercise if one’s blood sugar is too high (over 250), because it can sometimes raise blood sugar even higher.