title: Exercise training can modify the natural history of diabetic peripheral neuropathy.
abstract: BACKGROUND
  Diabetes is the most important cause of peripheral neuropathy (DPN). No definitive treatment for DPN has been established, and very few data on the role of exercise training on DPN have been reported.
  
  
  OBJECTIVE
  We sought to examine the effects of long-term exercise training on the development of DPN in both Types 1 and 2 diabetic patients.
  
  
  METHODS
  Seventy-eight diabetic patients without signs and symptoms of peripheral DPN were enrolled, randomized, and subdivided in two groups: 31 diabetic participants [15 f, 16 m; 49+/-15.5 years old; body mass index (BMI)=27.9+/-4.7], who performed a prescribed and supervised 4 h/week brisk walking on a treadmill at 50% to 85% of the heart rate reserve (exercise group: EXE), and a control group of 47 diabetic participants (CON; 24 f, 23 m; 52.9+/-13.4 years old; BMI=30.9+/-8.4). Vibration perception threshold (VPT), nerve distal latency (DL), nerve conduction velocity (NCV), and nerve action potential amplitude (NAPA) in the lower limbs were measured.
  
  
  RESULTS
  We found significant differences on Delta (delta) in NCV for both peroneal and sural motor nerve between the EXE and CON groups during the study period (P<.001, for both). The percentage of diabetic patients that developed motor neuropathy and sensory neuropathy during the 4 years of the study was significantly higher in the CON than the EXE group (17% vs. 0.0%, P<.05, and 29.8% vs. 6.45%, P<.05, respectively). In addition, the percentage of diabetic patients who developed increased VPT (25 V) during the study was significantly higher in the CON than the EXE group (21.3% vs. 12.9%, P<.05). Change on Hallux VPT from baseline to the end of the study was significantly different between the EXE and CON groups (P<.05); no significant change in Malleolus VPT between the two groups occurred.
  
  
  CONCLUSIONS
  This study suggests, for the first time, that long-term aerobic exercise training can prevent the onset or modify the natural history of DPN.
authors.affiliation: Health Care Team, Metabolic Fitness Association, Monterotondo, Rome, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Balducci
authors.forename: Gianluca
authors.initials: G
authors.lastname: Iacobellis
authors.forename: Leoluca
authors.initials: L
authors.lastname: Parisi
authors.forename: Nicolina
authors.initials: N
authors.lastname: Di Biase
authors.forename: Eugenio
authors.initials: E
authors.lastname: Calandriello
authors.forename: Frida
authors.initials: F
authors.lastname: Leonetti
authors.forename: Francesco
authors.initials: F
authors.lastname: Fallucca
mesh_terms: D000328:Adult; D003920:Diabetes Mellitus / Q000503:physiopathology / Q000628:therapy*; D003929:Diabetic Neuropathies / Q000175:diagnosis / Q000503:physiopathology / Q000517:prevention & control*; D003943:Diagnostic Techniques, Neurological; D018450:Disease Progression; D004568:Electrodiagnosis; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome