Complications of Type 1 Diabetes Mellitus are Associated with Renin Angiotensin System: The Role of Physical Exercise as Therapeutic Tool

Abstract

Type 1 diabetes mellitus (T1DM) is associated with the development of severe complications including cardiovascular diseases, nephropathy, retinopathy and neuropathy. The peptide Angiotensin II (Ang II), the main effector molecule of the renin angiotensin system (RAS), has been widely investigated because it plays an important role in the pathogenesis of T1DM and evidence in the literature suggests the pharmacological blockade of the RAS components as a potential therapeutic strategy to minimize the deleterious effects of T1DM by improving metabolism control, renal and cardiovascular functions.Physical exercise can also contribute to avoid the complications of T1DM by enhancing metabolism of carbohydrates and lipids, peak oxygen consumption, vascular function, autonomic response and arterial blood pressure. Furthermore, the physical exercise is able to reduce the level of tissue RAS. Thus, part of the benefits of physical exercise for prevention and treatment of metabolic and cardiovascular diseases in T1DM may be mediated by the RAS. The present review aimed to discuss the evidence regarding the involvement of the RAS in the progression of T1DM, the relevance of physical exercise to the management of T1DM and the role of physical exercise to induce adaptations in the RAS.