Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Dec 10, 2015; 6(17): 1323-1336
Published online Dec 10, 2015. doi: 10.4239/wjd.v6.i17.1323
Skeletal muscle as a therapeutic target for delaying type 1 diabetic complications
Samantha K Coleman, Irena A Rebalka, Donna M D’Souza, Thomas J Hawke
Samantha K Coleman, Irena A Rebalka, Donna M D’Souza, Thomas J Hawke, Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON L8S 4L8, Canada
Author contributions: All authors equally contributed to the research, analysis, writing and editing of this report.
Conflict-of-interest statement: Authors declare no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Thomas J Hawke, PhD, Department of Pathology and Molecular Medicine, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada.
Telephone: +1-905-5259140
Received: August 7, 2015
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.

Keywords: Type 1 diabetes mellitus, Skeletal muscle, Exercise, Myostatin, Leptin, Adiponectin, Metabolism

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.