A new study published, in Diabetologia has found that poor muscle health may be a complication of Type 1 diabetes (T1D), even among physically active 20-somethings. The researchers found structural and functional changes in the mitochondria (power generation parts of the cell), of those with diabetes. Mitochondria in T1D individuals were not only having reduced capability to produce energy for the muscle, but also released high amounts of toxic reactive oxygen species, related to cell damage.

Such structural and functional changes could lead to reduced metabolism, greater difficulty controlling blood glucose and, if left unchecked, an accelerated rate of developing disability. The study findings add poor muscle health to the list of better-known complications of T1D, including nerve damage, heart disease and kidney disorders.

"Now we know that even active people with diabetes have changes in their muscles that could impair their ability to manage blood sugar," said Thomas Hawke, corresponding author of the study and a professor of pathology and molecular medicine at McMaster University, Canada. "Knowing in the long term that this could contribute to faster development of disability, we can start to address it early on."

Christopher Perry, study co-senior author and an associate professor in kinesiology and health sciences at the Muscle Health Research Centre, York University, Canada, added: "Skeletal muscle is our largest metabolic organ and is the primary tissue for clearing blood sugar after eating a meal, so we need to keep muscle as healthy as possible."

Regular aerobic exercise increases the amount of mitochondria in muscles and thus helps muscle cells to use more glucose and become more efficient. According to Perry, their study suggests that current guidelines for T1D may also need to be revised.

"We believe these dysfunctional mitochondria are what's causing the muscle to not use glucose properly and to also damage muscle cells in the process. We were surprised to see the muscles were this unhealthy in young adults with T1D who were regularly active."

Researchers say while further study is needed to assess the impact of T1D in those who are sedentary, as well as those who meet or exceed physical activity recommendations, revising the evidence-based exercise guidelines, specific for those with T1D, may be required to keep them in the best health.

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