Vakgroep Menselijke fysiologie (MFYS)

Patients with Type 1 Diabetes (T1D) show a modest, but significant decline in their cognitive function compared to healthy controls. This cognitive decline is manifested through a deceleration of mental speed and a diminished mental flexibility. Hence, patients with T1D are less able to flexibly apply acquired knowledge in a new situation. Even if the decline in cognitive function is modest, it could significantly influence daily activities of T1D patients, negatively affecting patients’ Quality of Life (QOL).
According to the literature, mechanisms for cognitive decline are ascribed to episodes of severe hypoglycaemia, chronic hyperglycemia  and C-peptide/insulin deficiency. Because the brain cannot synthesize or store glucose, it requires continuous supply of glucose. Therefore, it is not inconceivable that the disruption of glucose supply by hypoglycaemia and/or chronic hyperglycaemia (expressed as high glycated haemoglobin levels (HbA1c)) will cause disturbances of the cognitive function.

Furthermore, it is well-known that physical exercise and training has beneficial effects on the cognitive function in humans with Alzheimer disease, dementia, elderly ... It is also known that exercise improves diabetes specific  parameters. Our meta-analysis successfully demonstrated an improvement in glycemic control induced by aerobic training. Aerobic exercise is well known to enhance insulin action 24h following both acute exercise. Therefore, it is recommended that exercise is performed frequently in order to maintain a constant increase in insulin sensitivity and thus improve glycaemic control. While acute aerobic exercise elicits acute marked falls in glycaemia which can often result in episodes of hypoglycaemia, this same meta-analysis revealed that there was a smaller fall of blood glucose levels when acute bouts of High Intensity Exercise (HIE) are added to aerobic training sessions compared to an acute bout of aerobic exercise without HIE. In this way, chronic hyperglycaemia could be prevented by performing regular aerobic exercise while hypoglycaemia could be prevented by adding bouts of HIE to an aerobic exercise session.

Since episodes of hypoglycaemia and chronic hyperglycaemia are both triggers for sustaining a diabetes-associated cognitive decline and both are influenced by exercise, we investigate the possible link between these parameters in this research line.