ESPE Abstracts

Type 1 Diabetes (T1DM) is a chronic metabolic disease characterized by hyperglycemia due to absolute insulin deficiency as a result of autoimmune damage of pancreatic β cells. In its treatment, insulin, medical nutrition therapy and exercise is recommended. Although it is known that exercise contributes to disease control, the mechanism of these effects has not been fully clarified. It is thought that myokines such as irisin and sestrin, can be effective by secreting with exercise, turning white fat tissue into brown.

Aim: This study aimed to compare serum irisin and sestrin levels between patients with T1DM and healthy controls, determine the changes in the clinical and laboratory findings of the patients with T1DM before and after exercise program and evaluate relationships of these changes with the levels of irisin and sestrin.

Materials and Methods: 33 patients with T1DM diagnosis and 36 control groups were involved. Firstly, exercise capacities (MaxVO2) and Physical Activity Status (PAS) were determined in T1DM and control groups and serum Irisin and sestrin levels measured in both groups. Secondly T1DM patients attended to the online exercise program 3 days a week for 3 months due to COVID19 restictions. At the end of the exercise program, 10 of the T1DM patients (exercised group) participated in at least 50% of the program. MaxVO2, PAS, serum irisin and sestrin levels were reevaluated and compared with the previous results in exercised and non-exercised groups. Their examinations were obtained from file data and computer records. Changes in laboratory and clinical findings were compared.

Results: Sestrin level was higher in the T1DM group than in the control group (P=0.003). This is the first data on sestrin and type one diabetes. There was no significant difference in irisin levels between T1DM and control groups (P=0.511). Both groups were sedentary due to the Covid19 lockdown. There was positive correlation between Irisin and maxVO2 in the patients with T1DM and control groups (r=0,34, P=0,02). In the second part of the study, irisin levels increased in the exercised group (P=0.012) and sestrin levels decreased in the non-exercised group (P<0.001). Physical activity score improved in the exercised group (P=0,028) and exercise capacity increased in both groups (<0,001). HbA1c levels decreased (P=0,032) and basal insulin requirement decreased (P=0,038) in the exercised group, unlike the non-exercised group.

Conclusion: Our findings suggest that the irisin and sestrin could contribute to the curative effects of exercise in type one diabetic children.