ISSN 2415-3060 (print), ISSN 2522-4972 (online)
  • 23 of 67
УЖМБС 2020, 5(3): 179–186
Clinical Medicine

The Effect of Metered Physical Exercise on the Level of Cytokines and Carbohydrate Metabolism in Patients with Type 2 Diabetes

Gorbach T. V.1, Butko Ya. O.2, Martynova S. N.1, Yakhno Yu. E.1

Diabetes mellitus is a very common disease of our age that leads to blindness and kidney failure. Type 2 diabetes mellitus accounts for an average of 80% of the total number of patients. More often it develops in adulthood, but nowadays it also occurs among children. Insulin deficiency in such patients develops gradually, with age, on the background of various factors (obesity, hypodynamia, some nutritional features, etc.). Insulin deficiency in the body gradually increases and leads to the emergence of pronounced (absolute) insulin deficiency, requiring the appointment of patients with insulin preparations. In our time, many researchers have been interested in the question of the involvement of cytokines in the mechanism of diabetes and its complications. Clinical studies showed that the development of complications of diabetes is associated with increased levels of IL-1, TNF-α, IL-6, IL-8. It was found that the content of these interleukins in the serum is affected by myokines, hormone-like substances that are secreted during muscle activity in the blood and have a regulatory effect on metabolism. However, there are very few experimental studies on the effect of physical activity on metabolic rates in patients with type 2 diabetes. Material and methods. In our research, 40 patients aged 40-55 years (12 men and 28 women) participated in treatment at the endocrinological department of the Kharkiv Regional Clinical Hospital, as well as at the Clinic of the State Institution of Problems of Endocrine Pathology named after V. Ya. Danilev AMS of Ukraine with clinically established diagnosis diabetes mellitus type 2. Duration of the disease ranged from 3 to 5 age. All patients had subcompensation of carbohydrate metabolism index, body mass index was from 24.5 to 38 kg / m2. All patients received metformin, the control group consisted of 15 healthy people of the same age (6 men and 9 women). Results and discussion. The survey of patients showed that they all had a sedentary lifestyle (not more than 1.5 km per day), and did not take exercises, spent a lot of time at the computer. In this regard, patients were interviewed about the possibility of improving the effectiveness of treatment and prevention of complications of diabetes with the help of increasing motor activity, using sports walking, regular exercise, swimming, and pilates. As a result, after being discharged from the hospital, 10 people (women) began to attend pilates classes twice a week (duration of the lesson 1:00), 15 people (5 men and 10 women) went for a "Swedish" walk (at least 4 times a week for 1 , 5:00). The rest of the patients did not change their usual lifestyle. In all patients 6 months after discharge from the hospital were repeated biochemical studies of parameters of blood and saliva. It was noted that the dosage of muscular activity (Pilates exercise 1:00 2 times a week or exercise walking 4 times a week for 1.5 hours) increases the secretion of IL-10 and IL-6, decreases the concentration of IL-1ß and FNS - α in saliva of patients with diabetes mellitus 2, the magnitude of the changes is proportional to the duration of the load. Conclusion. The study showed that motor activity contributed to a decrease in the level of insulin resistance, normalization of carbohydrate metabolism in patients with SD-2, improvements were more pronounced in patients engaged in “Swedish” walking.

Keywords: diabetes mellitus, motor activity, interleukins, insulin, glycosylated hemoglobin

Full text: PDF (Ukr) 227K

  1. Kologrivova OV, Serkova TE. Funktsionirovanie effektornykh i regulyatornykh T-limfotsitov pri narushenii tolerantnosti k uglevodam i sakharnom diabete 2 tipa, assotsiirovannom s arterialnoy gipertenziey [The functioning of effector and regulatory T-lymphocytes in violation of tolerance to carbohydrates and type 2 diabetes mellitus associated with arterial hypertension]. Tsitokiny i vospalenie. 2012; 2: 38-43. [Russian]
  2. Wada J, Makim H. Inflammation and the pathogenesis of diabeta nephropathy. Clin Sci (Lond). 2013; 124(3): 139-62.
  3. World Health Organization, WHO. [Internet]. [Ukrainian]. Available from:
  4. Dedov II, Remizov OV, Peterkova VA. Sakharnyy diabet 2 tipa u detey i podrostkov [Type 2 diabetes in children and adolescents]. Sakharnyy diabet. 2001; 4: 26-31. [Russian]
  5. Klebanova FM, Balabolkin MI, Kremiskaya VM. Znachenie zhirovoy tkani i ee gormonov v mekhanizmakh insulinovoy rezistentnosti i razvitii sakharnogo diabeta 2 tipa [The importance of adipose tissue and its hormones in the mechanisms of insulin resistance and the development of type 2 diabetes]. Klin Med. 2008; 7: 20-7. [Russian]
  6. Dotsenko EA, Yupatov RI, Chirki AA. Kholesterin I lipoproteiny nizkoy plotnosti kak endogennye immunomodulyatory [Cholesterol and low density lipoproteins as endogenous immunomodulators]. Immunopatologiya, allergologiya, infektologiya. 2007; 3: 6-15. [Russian]
  7. Bondar IA, Shabelnikova OYu. Markery vospaleniya u bolnykh sakharnym diabetom 2 tipa s kardiovaskulyarnoy formoy diabeticheskoy avtonomnoy neyropatii [Markers of inflammation in patients with type 2 diabetes with a cardiovascular form of diabetic autonomic neuropathy]. Sakharnyy diabet. 2009; 4: 52-5. [Russian]
  8. Kopeniv VI, Klimontov VV, Myakina NE, Tyan NV. Povyshenie kontsentratsii vospalitelnykh tsitokinov v syvorotke krovi bolnykh SD2 s khronicheskim zabolevaniem pochek [Increased concentration of inflammatory cytokines in the blood serum of patients with type 2 diabetes with chronic kidney disease]. Terapevticheskiy arkhiv. 2015; 6: 45-9. [Russian]
  9. Chizuko H, Yoshihiro K, Koji N. Levels of the IL-1 and TNF-α un the peripheric blood of the patients with diabetes melliyus Type 2 with microvascular disease. Tohyobyo. 2008; 2: 149-53.
  10. Andreeva LS, Khamnueva LYu, Shagun OV. Rol tsitokinov v patogeneze sakharnogo diabeta [The role of cytokines in the pathogenesis of diabetes mellitus]. Sibirskiy meditsinskiy zhurnal (Irkutsk). 2013; 2: 4-8. [Russian]
  11. Pavlovskiy SA. Otsenka soderzhaniya tsitokinov v krovi bolnykh nealkogolnym steatogepatitom, sochetannym s SD2, pod vliyaniem kombinirovannoy sakharosnizhayushchey terapii [Assessment of cytokines in the blood of patients with non-alcoholic steatohepatitis, combined with type 2 diabetes, under the influence of combined hypoglycemic therapy]. Meditsina. 2018; 1-2(143): 170-5. [Russian]
  12. Pedersen BK, Akerstrom TA, Nielsen AR, Fischer CP. Role of myokines in exercise and metabolism. J Appl Physiol. 2007; 103: 1093-98.
  13. Sebaratnam R, Pedersen A, Kristensem J, Handberg A, Wojtaszewski J. Intact regulation of muscle expression and circulating levels of myokines in response to exercise in patients with type 2 diabetes. Physiol Red. 2018 Jun; 6(12): e13723.
  14. Karimi H, Rehman S, Gillani S. Effects of Supervised Structured Aerobic Exercise Training Program on Interleukin-6, Nitric Oxide Synthase-1, and Cyclooxygenase-2 in Type 2 Diabetes Mellitus. J Coll Physicians Surg Pak. 2017 Jun; 27(6): 352-5.
  15. Kurauti MA, Costa-Júnior JM, Ferreira SM, Santos GJ, Sponton CHG, Carneiro EM, et al. Interleukin-6 increases the expression and activity of insulin-degrading enzyme. Sci Rep. 2017 Apr 21; 7: 46750.