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Could a simple lifestyle change reduce health risks of Type 1 diabetes?

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Published on 08 March 2021

Lifestyle changes
Lifestyle changes

Dr Matthew Campbell at the University of Sunderland is leading a study into whether breaking up prolonged sitting time with short frequent bouts of light-intensity walking can improve glucose levels and reduce risk factors associated with T1D complications.

Working in collaboration with the University of Cambridge and University of Leeds, the 18-month project has received funding in excess of £100k from national charity Diabetes UK.

Research has already shown there are benefits with these small changes to people with and without Type 2 Diabetes (T2D) in lowering glucose levels across the whole day, including mealtimes and during the night.

However, to date there has been no research in this area for those living with T1D, in particular the risk of dangerous glucose lows (hypoglycaemia), or whether this approach can lower the risk of developing complications which includes heart and blood vessel disease, nerve damage, kidney damage, eye damage and foot damage.

Dr Campbell, Principal Investigator in Human Metabolism in the Faculty of Health Sciences and Wellbeing, explained: “Our research will address an urgent unmet need for those with T1D. Sitting for long periods of time is harmful to our health. In people with diabetes, this has been shown to contribute to poorer glucose control and an increased risk of developing diabetes complications.

“The NHS and Diabetes UK recommend and encourage all people with diabetes to become more physically active; people with T1D are at least as inactive as the general population.

"While you may meet the physical activity guidelines, if you sit for long periods of time, you may still fall into the category of having a sedentary lifestyle.

"Simple and acceptable methods that enable people to incorporate physical activity more easily into everyday life and reduce the amount of time spent sitting are urgently needed for people with T1D."

In the UK, T1D affects approximately 400,000 people which is around 10% of the total number of people living with diabetes.

The study will include monitoring glucose levels using the latest technology and collecting blood samples from a group of more than 30 T1D volunteers, to discover if short frequent bouts of light-intensity walking improve glucose levels and any risk factors associated with diabetes complications in people with T1D.

Dr Elizabeth Robertson, Director of Research at Diabetes UK, said:“Dr Campbell’s research will investigate whether people with T1D could benefit from making subtle lifestyle changes. With many of us spending more time sitting as a result of the pandemic, this research is more important than ever. We’re proud to be funding this work at such a critical time, and hope it will lead to new, more achievable ways for people with type 1 diabetes to manage their glucose levels, reduce their risk of serious complications and protect their overall health.”

Dr Campbell, who has published extensively in the area of diabetes and glucose regulation, says when physical activity is promoted by healthcare professionals, it is often exercise, rather than lower-intensity activities tends to be encouraged to promote movement across the day. But, for most inactive people, exercise can often be viewed as daunting or unachievable and its promotion can discourage individuals from becoming active. However, he adds that reducing the time spent inactive and focusing on lower-intensity activities is often viewed as achievable and a good starting point for many.

He says: “For some people with T1D this approach may be viewed as an important ’stepping-stone’ towards more regular participation in physical activity or exercise, whereas for others, it may be a simple and acceptable intervention to achieve better glucose control in its own right and reduce the risk of future complications.”

It’s hoped that the study results may influence treatment decisions and clinical consensus, where suitable.

The study will also provide vital proof-of-concept evidence to inform larger outcome trials that more comprehensively establish safety and effectiveness over the longer-term in a more diverse group of people with T1D (for example, in people with established diabetes complications, different fitness levels, or individuals struggling with weight-management).

 

About

Dr Matthew Campbell

Principal Investigator in Human Metabolism in the Faculty of Health Sciences and Wellbeing. Dr Campbell also holds honorary titles at the Wellcome-MRC Institute of Metabolic Science (University of Cambridge), the Leeds Institute for Metabolic and Cardiovascular Medicine (University of Leeds), and Zhejiang Gongshang University.

His work has developed effective self-management strategies for the avoidance of exercise-induced hypoglycaemia and late post-prandial hyperglycaemia which informed the landmark Exercise Management in Type 1 Diabetes Consensus Statement, and the American Diabetes Association Position Statement for Physical Activity and Exercise.

About Diabetes UK

1.   Diabetes UK’s aim is creating a world where diabetes can do no harm. Diabetes is the most devastating and fastest growing health crisis of our time, affecting more people than any other serious health condition in the UK - more than dementia and cancer combined. There is currently no known cure for any type of diabetes. With the right treatment, knowledge and support people living with diabetes can lead a long, full and healthy life. For more information about diabetes and the charity’s work, visit www.diabetes.org.uk  

2.   Diabetes is a condition where there is too much glucose in the blood because the body cannot use it properly. If not managed well, both type 1 and type 2 diabetes can lead to devastating complications. Diabetes is one of the leading causes of preventable sight loss in people of working age in the UK and is a major cause of lower limb amputation, kidney failure and stroke. 

3.   People with type 1 diabetes cannot produce insulin. About 8 per cent of people with diabetes have type 1. No one knows exactly what causes it, but it’s not to do with being overweight and it isn’t currently preventable. It’s the most common type of diabetes in children and young adults, starting suddenly and getting worse quickly. Type 1 diabetes is treated by daily insulin doses – taken either by injections or via an insulin pump. It is also recommended to follow a healthy diet and take regular physical activity.

4.   People with type 2 diabetes don’t produce enough insulin or the insulin they produce doesn’t work properly (known as insulin resistance). Around 90 per cent of people with diabetes have type 2. They might get type 2 diabetes because of their family history, age and ethnic background puts them at increased risk. They are also more likely to get type 2 diabetes if they are overweight. It starts gradually, usually later in life, and it can be years before they realise they have it. Type 2 diabetes is treated with a healthy diet and increased physical activity. In addition, tablets and/or insulin can be required. 

5.   About 2 per cent of people have other types of diabetes. Other types include 11 different forms of monogenic diabetes, cystic fibrosis related diabetes and diabetes caused by rare syndromes. Certain medication such as steroids and antipsychotics, surgery or hormonal imbalances could also lead to other types of diabetes.  

 

For more information on reporting on diabetes, download our journalists’ guide: Diabetes in the News: A Guide for Journalists on Reporting on Diabetes (PDF, 3MB).