Published online Dec 10, 2015. doi: 10.4239/wjd.v6.i17.1323
Peer-review started: August 21, 2015
First decision: September 30, 2015
Revised: October 1, 2015
Accepted: November 23, 2015
Article in press: November 25, 2015
Published online: December 10, 2015
Type 1 diabetes mellitus (T1DM) is a chronic autoimmune disease targeting the pancreatic beta-cells and rendering the person hypoinsulinemic and hyperglycemic. Despite exogenous insulin therapy, individuals with T1DM will invariably develop long-term complications such as blindness, kidney failure and cardiovascular disease. Though often overlooked, skeletal muscle is also adversely affected in T1DM, with both physical and metabolic derangements reported. As the largest metabolic organ in the body, impairments to skeletal muscle health in T1DM would impact insulin sensitivity, glucose/lipid disposal and basal metabolic rate and thus affect the ability of persons with T1DM to manage their disease. In this review, we discuss the impact of T1DM on skeletal muscle health with a particular focus on the proposed mechanisms involved. We then identify and discuss established and potential adjuvant therapies which, in association with insulin therapy, would improve the health of skeletal muscle in those with T1DM and thereby improve disease management- ultimately delaying the onset and severity of other long-term diabetic complications.
Core tip: Skeletal muscle is adversely affected in type 1 diabetes mellitus and strategies to maintain/improve muscle health will positively impact disease management and delay diabetic complications.