Funk Deanna R, Boulé Normand G, Senior Peter A, Yardley Jane E
a Augustana Faculty, University of Alberta., 4901 - 46th Avenue Camrose, AB T4V 2R3, Canada.
b Faculty of Physical Education and Recreation, University of Alberta. 1-059D, Li Ka Shing Centre for Health Research Innovation, Edmonton, AB T6G 2E1, Canada.
Appl Physiol Nutr Metab. 2017 Jan;42(1):1-7. doi: 10.1139/apnm-2016-0402. Epub 2016 Oct 26.
Islet transplantation (ITx) is effective in preventing severe hypoglycemia by restoring glucose-dependent insulin secretion in type 1 diabetes (T1D), but may not normalize glucose regulation. Studies suggest that physical activity plays a role in maintaining β-cell mass and function in individuals with type 2 diabetes and animal models of diabetes. This could indicate that physical activity plays a role in graft survival in ITx recipients. This review's objective is to assess current knowledge related to physical activity in ITx recipients. Responses to other challenges in blood glucose control (i.e., hypoglycemia) in human ITx recipients were examined to provide in-depth background information. To identify studies involving exercise in ITx recipients, a systematic search was performed using PubMed, Medline, and Embase, which revealed 277 English language publications. Publications were excluded if they did not involve ITx recipients; did not involve physical activity or hypoglycemia; or did not report on glucose, insulin, or counterregulatory hormones. During induced hypoglycemia, studies indicate normal suppression of insulin in ITx individuals compared with healthy non-T1D controls. Studies involving exercise in ITx animals have conflicting results, with time since transplantation and transplantation site (spleen, liver, kidney, peritoneal cavity) as possible confounders. No study examining blood glucose responses to physical activity in human ITx recipients was identified. A small number of induced-hypoglycemia studies in humans, and exercise studies in animals, would suggest that glucoregulation is greatly improved yet is still imperfect in this population and that ITx does not fully restore counterregulatory responses to challenges in blood glucose homeostasis.
胰岛移植（ITx）通过恢复1型糖尿病（T1D）患者的葡萄糖依赖性胰岛素分泌，在预防严重低血糖方面是有效的，但可能无法使血糖调节正常化。研究表明，体育活动在2型糖尿病患者和糖尿病动物模型中对维持β细胞质量和功能发挥作用。这可能表明体育活动在胰岛移植受者的移植物存活中发挥作用。本综述的目的是评估与胰岛移植受者体育活动相关的现有知识。研究了人类胰岛移植受者对血糖控制中其他挑战（即低血糖）的反应，以提供深入的背景信息。为了确定涉及胰岛移植受者运动的研究，使用PubMed、Medline和Embase进行了系统检索，共检索到277篇英文出版物。如果出版物不涉及胰岛移植受者；不涉及体育活动或低血糖；或未报告血糖、胰岛素或反调节激素，则将其排除。在诱导低血糖期间，研究表明与健康的非T1D对照相比，胰岛移植个体的胰岛素正常抑制。涉及胰岛移植动物运动的研究结果相互矛盾，移植后的时间和移植部位（脾脏、肝脏、肾脏、腹腔）可能是混杂因素。未发现有研究检测人类胰岛移植受者对体育活动的血糖反应。少数关于人类诱导低血糖的研究和动物运动研究表明，该人群的血糖调节有了很大改善，但仍不完善，胰岛移植不能完全恢复对血糖稳态挑战的反调节反应。
