Exercise Training, Lactate Threshold and Type ۳ Diabetes

There are several theories out there to explain the crosstalk among T۲DM, dementia and type ۳ diabetes mellitus (T۳DM) that promote extensive neuronal loss leading to brain atrophy and neuronal dysfunction. Due to the overlapping yet distinct pathological features among diabetes, insulin resistance and cognitive decline, insulin-related therapeutic strategies such as lifestyle interventions and exercise training are suggested to succeed in the development of therapies in neuro-metabolic dysfunctions. Disease-modifying interventions as the first line of cognitive impairments treatment are targeting to brain structure and function. Recent reports illustrated that exercise-based interventions such as resistance and aerobic training have beneficial effects on patients with diabetic brain. But, the most individuals with cognitive impairment may not learn how to transfer increased muscle strength to improve functional task definitively and may have difficulties in performing complex activities of daily living. Functional training is a specific rehabilitation intervention in more realistic environments that use to improve daily activity performance and include balance training, sensory integration exercises, and posture exercises, core muscle stability training.Since ۱۹۸۸, there are evidences that lactate has neuroprotective and therapeutic effects on different types of brain disorders. Studies indicate that lactate or its receptors are involved in various effects of exercise on the brain and may be the initial molecular signal between exercise and beneficial adaptation of the brain.Lactate can cross the blood-brain barrier (BBB) reaching neurons via monocarboxylate transporters (MCT) and plays a crucial role for memory formation and could be a link between exercise and neuroplasticity. Van de Hall et al. have shown that lactate uptake in the brain increases from ۸% at rest up to ۲۰% during exercise. Previous studies have found that both exercise and lactate injection can promote neurogenesis. It has been reported that following acute sprint interval training there was higher levels of peripheral blood lactate that was associated with higher levels of BDNF, IGF-۱, and VEGF, which is also related to better performance in cognitive function tests.It has been well shown that blood lactate levels increase significantly only when exercise intensity exceeds the lactate threshold, and it has been shown that lactate produced by high-intensity exercise mediates the beneficial effects of exercise on the brain. Paradoxically, moderate- and low-intensity exercise that does not increase blood lactate has many beneficial effects on the brain in many studies, including improvements in BDNF levels, nerve regeneration, vascular regeneration, and cognitive function. In fact, different types of exercise can activate brain neuron activity.

Keywords:

Exercise , lactate , Type ۳ Diabetes , Alzheimer's disease