The long-term effects of physical activity on blood glucose regulation: a model to unravel diabetes progression

Physical activity plays a key role in the prevention of type 2 diabetes. However, despite the numerous clinical evidences, there are still no mathematical models that satisfactorily describe the effects of physical activity on the progression of diabetes, preventing its onset or slowing down its course. Instead, there are models describing the influence of single training sessions of physical activity on blood glucose and insulin levels in the short term. In this letter we propose a novel model for the long term effects of physical activity on diabetes progression, by exploiting and adapting an existing short-term model of physical activity. A pivotal role in the proposed model is played by interleukin-6 released during physical activity and known to be fundamental in maintaining pancreatic beta cells production and therefore satisfactory insulin secretion. The proposed simulation scenarios show how a modeling approach of physical activity that neglects the interleukin-6 action is not sufficient to capture the cumulative effects of physical exercise on disease progression. Indeed, preliminary results pave the way to natural extensions of the model to account for model-based control techniques for the long-term control of diabetes through personalized lifestyle interventions, properly accounting for the effects of physical activity on the long-term dynamics of blood glucose