A review of apoptosis in diabetic patients with the approach of exercise activity

Background and aims: Exercise activities can help to reduce and control apoptosis-related damage in patients with diabetes. This research aimed to review studies investigating the effects of exercise on apoptosis in diabetic patients. Methods: We conducted a search for studies examining the response of apoptosis signaling pathways to aerobic, resistance, and high-intensity interval training (HIIT) exercise in diabetic patients. This was accomplished using scientific national and international databases focusing on keywords such as "The role of apoptosis in diabetes," "Intrinsic and extrinsic pathways of apoptosis," "aerobic exercise and apoptosis," and "resistance and high-intensity interval training in diabetic patients." Results: Our review covered three articles related to the intrinsic pathway of apoptosis, three on the extrinsic pathway, and five addressing apoptosis specifically in diabetic patients. We identified six articles discussing the effects of aerobic exercise on apoptosis signaling pathways, one article on resistance exercises, and five on the implications of HIIT on apoptosis across various types of diabetes. The findings suggest that aerobic, resistance, and HIIT exercise interventions increase Bcl-2 expression while decreasing the expression of Bax, Bcl-xL, p53 protein, and caspase-3, ultimately delaying the process of apoptosis in diabetic patients. Conclusion: Regular participation in aerobic, resistance, and HIIT activities appears to have beneficial effects on anti-apoptotic biomarkers in diabetic patients, thereby controlling apoptosis. Consequently, a combination of HIIT and aerobic exercises is recommended as an effective non-pharmacological strategy to manage apoptosis in patients with diabetes.