Active Subjects with Autoimmune Type 1 Diabetes Have Better Metabolic Profiles than Sedentary Controls

Previous studies in humans with type 1 diabetes (T1D) and in non-obese diabetic mice have investigated the beneficial immunomodulatory potential of aerobic physical activity. Performing high volume of aerobic exercise may favorably regulate autoimmunity in diabetes. We tested whether increased physical activity is a self-sufficient positive factor in T1D subjects. During a 3-month observational period, active (6M; 40.5\ub16.1 years; BMI 24.5\ub12.1) and sedentary (4M, 3F; 35.9\ub18.9 years; BMI 25.7\ub13.8) T1D individuals on insulin pump therapy were studied for metabolic, inflammatory and autoimmune parameters. At baseline and at the end of a 3-month period, glycosylated hemoglobin (HbA1c), auto-antibodies (anti-GAD, anti-ZnT8, anti-IA2, ICA) and pro-inflammatory cytokines (IL-6 and TNF-\u3b1) were evaluated. During the 3rd month of the period, physically active T1D patients showed a significant reduction in the average glucose levels (-9%, p=0.025, by CGM) compared to the 1st-month values, and even their hyperglycemic episodes (>180mg/dL) diminished significantly (-24.2%, p=0.032 vs 1st month). Moreover, active T1D subjects exhibited an improved body composition with respect to sedentary controls. No significant changes were detected as to the autoimmune and inflammatory profiles. This study confirms the beneficial role of physical exercise associated with insulin pump therapy in order to improve metabolic control in individuals with T1D. These preliminary positive observations need to be challenged in a prolonged interventional follow-up

Brain energy rescue:an emerging therapeutic concept for neurodegenerative disorders of ageing

The brain requires a continuous supply of energy in the form of ATP, most of which is produced from glucose by oxidative phosphorylation in mitochondria, complemented by aerobic glycolysis in the cytoplasm. When glucose levels are limited, ketone bodies generated in the liver and lactate derived from exercising skeletal muscle can also become important energy substrates for the brain. In neurodegenerative disorders of ageing, brain glucose metabolism deteriorates in a progressive, region-specific and disease-specific manner — a problem that is best characterized in Alzheimer disease, where it begins presymptomatically. This Review discusses the status and prospects of therapeutic strategies for countering neurodegenerative disorders of ageing by improving, preserving or rescuing brain energetics. The approaches described include restoring oxidative phosphorylation and glycolysis, increasing insulin sensitivity, correcting mitochondrial dysfunction, ketone-based interventions, acting via hormones that modulate cerebral energetics, RNA therapeutics and complementary multimodal lifestyle changes

Stiff person syndrome does not always occur with maternal passive transfer of GAD65 antibodies

The authors report the presence of high titer antibodies to glutamic acid decarboxylase (anti-GAD65) until age 24 months in two asymptomatic newborns of a woman with stiff-person syndrome (SPS). No signs of SPS were detectable in the two children at ages 6 and 8 years. This observation indicates that other cofactors are involved in the pathogenesis of SPS