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The Impact of Physical Activity on Young Type 1 Diabetes Patients

Physical activity intervention had a positive impact on reducing HbA1c, BMI and total cholesterol but insulin dosage did not change in the study…

Due to the increased risk of cardiovascular disease in type 1 diabetes patients, physical activity is advised. This recommendation is used in combination with insulin therapy and certain dietary modifications. While recommendations are in place to suggest regular physical activity in the type 1 diabetes youth population, young people with diabetes may still be less active than nondiabetes youth.

The purpose of this meta-analysis was to determine the impact physical activity interventions had on health outcomes in young type 1 diabetes patients. The literature search included both randomized and non-randomized trials. A total of 26 studies were included in this meta-analysis. Physical activity was defined as aerobic alone or in combination with strength training. Those in control groups were advised to continue their normal daily activities. Intensity of physical activity was not reported in all of the studies. Outcomes assessed in this analysis included HbA1c, total cholesterol, body mass index and daily insulin dose.

The results of the meta-analysis showed a reduction in HbA1c as a result of a physical activity intervention (standardized mean difference -0.52, 95% CI -0.97 to -0.07, P=0.02). A reduction in total cholesterol was also seen (standardized mean difference -0.91, 95% CI -1.66 to 0.17, P=0.02). A decrease in body mass index was observed in the intervention group (standardized mean difference -0.41, 95% CI -0.70 to -0.12, P=0.006). A change in daily insulin dose was not observed when comparing the intervention group to the control group (P=0.07).

The researchers concluded that improvements were seen in reducing HbA1c, body mass index and total cholesterol. Each of these health outcomes can lower the risk of cardiovascular disease and other complications associated with diabetes. Physical activity and intensity varied widely across the studies used for this analysis. Future studies can be performed to determine which specific type of physical activity intervention can provide the best outcomes for patients in this population.

Practice Pearls:

  • Young patients with type 1 diabetes are at increased risk for cardiovascular disease and microvascular complications
  • While physical activity is encouraged in type 1 diabetes patients, many young patients might still be less active than healthy individuals
  • Studies from this meta-analysis showed a physical activity intervention can have a positive impact on reducing HbA1c, body mass index and total cholesterol in type 1 diabetes subjects

Quirk H, Blake H, Tennyson R, Randell TL and Glazebrook C. Phsyical activity interventions in children and young people with Type 1 diabetes mellitus: a systematic review with meta-analysis. Diabetic Medicine. 2014.