Effect of Regular Physical Activity and Lifestyle Changes on Insulin Resistance in Patients after Kidney Transplantation

Abstract Introduction: Insulin resistance (IR) at the time of kidney transplant (KT) is the most significant risk factor for the development of post-transplant diabetes mellitus (PTDM) and is a strong predictor of cardiovascular morbidity and mortality in patients after KT. It is possible to improve long-term survival of grafts and patients by influencing just modifiable risk factors, including obesity and the associated IR. The aim of this work is to determine the effect of regular physical activity and lifestyle changes on IR and other risk factors for PTDM in patients after KT. Material and methods: The primary goal was to complete at least 150 minutes of moderate intensity physical exertion per week. Study group (n = 22) performed an aerobic or combined (aerobic + anaerobic) type of sports activity. Monitoring was provided by a sports tracker (Xiaomi Mi Band 4 compatible with Mi Fit mobile application). Control group was consisted of 22 stable patients after KT. Patients in both groups have the same immunosuppressive protocol. The duration of follow-up was 6 months. Results: There were significantly lower waist circumference (P = 0.0437, P = 0.0372), better graft function (P = 0.0036, P = 0.0137), lower value of fasting blood glucose (P = 0.0016, P = 0.0003), C-peptide (P = 0.0447, P = 0014) in the 3rd and 6th month of monitoring and lower low-density lipoprotein at 6 months (P = 0.0444) in the observed group compared to the control group. IR was statistically significantly lower at 6 months (P = 0.0202) and fasting blood glucose at 3 and 6 months (P = 0.0227) in the observed group. In the monitored group, the subgroup performing intensive training achieved a significant additional effect on the reduction of waist circumference (P = 0.0173). Conclusion: In our study, we confirmed a significant effect of regular physical activity in preventing the development of IR and impaired fasting glucose in patients after KT. It is necessary to perform at least 150 minutes of medium-intensity aerobic or combined sport effort per week to achieve this goal.