title: Effects of non-supervised low intensity aerobic excise training on the microvascular endothelial function of patients with type 1 diabetes: a non-pharmacological interventional study.
abstract: BACKGROUND
  The aim of the present study was to evaluate changes in microvascular density and reactivity in patients with type 1 diabetes (T1D) resulting from low intensity chronic exercise training.
  
  
  METHODS
  This study included 22 (34 ± 7 ears) consecutive outpatients with T1D and disease duration > 6 years. We used intravital video-microscopy to measure basal skin capillary density and capillary recruitment using post-occlusive reactive hyperemia (PORH) in the dorsum of the fingers. Endothelium-dependent and -independent vasodilation of the skin microcirculation was evaluated in the forearm with a laser Doppler flow monitoring (LDF) system in combination with acetylcholine and sodium nitroprusside iontophoresis, PORH and local thermal hyperemia.
  
  
  RESULTS
  The basal mean capillary density (MCD) after exercise training was significantly higher than before exercise (134 ± 25 vs. 119 ± 19 capillaries/mm(2), respectively; P = 0.0013). MCD during PORH was also higher after exercise (140 ± 26 vs. 121 ± 24 capillaries/mm(2), respectively; P < 0.0001). Endothelium-dependent capillary recruitment during PORH was also significantly higher after exercise (140 ± 26 vs. 134 ± 25 capillaries/mm(2), respectively; P < 0.0012). There were no significant changes in skin microvascular reactivity after exercise as investigated using LDF.
  
  
  CONCLUSIONS
  Our results showed that low intensity aerobic exercise, performed four times per week for 12 weeks by patients with T1D, induces significant increases in microvascular density and endothelial-dependent capillary reactivity.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT02441504. Registered 7 May 2015.
authors.affiliation: National Institute of Cardiology, Rio de Janeiro, Brazil.|Laboratory of Cardiovascular Investigation, Oswaldo Cruz Institute, Av. Brasil, 4365, 21045-900, Rio de Janeiro, Brazil.|School of Physical Education and Sports Sciences of the Estácio de Sá University, Rio de Janeiro, Brazil.
authors.forename: Roger
authors.initials: R
authors.lastname: de Moraes
authors.affiliation: National Institute of Cardiology, Rio de Janeiro, Brazil.|Laboratory of Cardiovascular Investigation, Oswaldo Cruz Institute, Av. Brasil, 4365, 21045-900, Rio de Janeiro, Brazil.
authors.forename: Diogo
authors.initials: D
authors.lastname: Van Bavel
authors.affiliation: Department of Medicine, Diabetes Unit, State University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Marília de Brito
authors.initials: MB
authors.lastname: Gomes
authors.affiliation: National Institute of Cardiology, Rio de Janeiro, Brazil. etibi@ioc.fiocruz.br.|Laboratory of Cardiovascular Investigation, Oswaldo Cruz Institute, Av. Brasil, 4365, 21045-900, Rio de Janeiro, Brazil. etibi@ioc.fiocruz.br.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Tibiriçá
mesh_terms: D000109:Acetylcholine; D000328:Adult; D002196:Capillaries / Q000473:pathology / Q000503:physiopathology*; D003922:Diabetes Mellitus, Type 1 / Q000473:pathology / Q000503:physiopathology / Q000534:rehabilitation*; D004730:Endothelium, Vascular / Q000473:pathology / Q000503:physiopathology*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005385:Fingers / Q000098:blood supply; D005542:Forearm / Q000098:blood supply; D006801:Humans; D006940:Hyperemia / Q000503:physiopathology; D000069416:Intravital Microscopy; D007478:Iontophoresis; D017078:Laser-Doppler Flowmetry; D008297:Male; D018715:Microscopy, Video; D009599:Nitroprusside; D012039:Regional Blood Flow; D012867:Skin / Q000098:blood supply / Q000473:pathology; D016896:Treatment Outcome; D014664:Vasodilation / Q000502:physiology*; D014665:Vasodilator Agents
chemical_list: D014665:Vasodilator Agents; D009599:Nitroprusside; D000109:Acetylcholine
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