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Increase in physical activity is associated with lower HbA1c levels in children and adolescents with type 1 diabetes: Results from a cross-sectional study based on the Swedish pediatric diabetes quality registry (SWEDIABKIDS)

Published:February 22, 2014DOI:https://doi.org/10.1016/j.diabres.2014.01.029

      Abstract

      Aims

      To evaluate the associations between physical activity (PA) and metabolic control, measured by glycated hemoglobin (HbA1c), in a large group of children and adolescents with type 1 diabetes.

      Methods

      Cross-sectional analysis of data from 4655 patients, comparing HbA1c values with levels of physical activity. The data for the children and adolescents were obtained from the Swedish pediatric diabetes quality registry, SWEDIABKIDS. The patients were 7–18 years of age, had type 1 diabetes and were not in remission. Patients were grouped into five groups by frequency of PA.

      Results

      Mean HbA1c level was higher in the least physically active groups (PA0: 8.8% ± 1.5 (72 ± 16 mmol/mol)) than in the most physically active groups (PA4: 7.7% ± 1.0 (60 ± 11 mmol/mol)) (p < 0.001). An inverse dose–response association was found between PA and HbA1c (β: −0.30, 95% CI: −0.34 to −0.26, p < 0.001). This association was found in both sexes and all age groups, apart from girls aged 7–10 years. Multiple regression analysis revealed that the relationship remained significant (β: −0.21, 95% CI: −0.25 to −0.18, p < 0.001) when adjusted for possible confounding factors.

      Conclusions

      Physical activity seems to influence HbA1c levels in children and adolescents with type 1 diabetes. In clinical practice these patients should be recommended daily physical activity as a part of their treatment.

      Keywords

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      References

        • Zinman B.
        • Ruderman N.
        • Campaigne B.N.
        • Devlin J.T.
        • Schneider S.H.
        • American Diabetes Association
        Physical activity/exercise and diabetes mellitus.
        Diabetes Care. 2003; 26: 73-77
        • Chimen M.
        • Kennedy A.
        • Nirantharakumar K.
        • Pang T.T.
        • Andrews R.
        • Narendran P.
        What are the health benefits of physical activity in type 1 diabetes mellitus? A literature review.
        Diabetologia. 2012; 55: 542-551
        • Strong W.B.
        • Malina R.M.
        • Blimkie C.J.
        • Daniles S.R.
        • Dishman R.K.
        • Gutin B.
        • et al.
        Evidence based physical activity for school-age youth.
        J Pediatr. 2005; 146: 732-737
        • Adolfsson P.
        Motion sport och idrott.
        in: Sjöblad S. Barn-och ungdomsdiabetes. 2nd ed. Lund, Studentlitteratur2008
        • Miculis C.P.
        • Mascarenhas L.P.
        • Boguszewski M.C.S.
        • De Campos W.
        Physical activity in children with type 1 diabetes.
        J Pediatr (Rio J). 2010; 86: 271-278
        • Herbst A.
        • Bachran R.
        • Kapellen T.
        • Holl R.W.
        Effects of regular physical activity on control of glycemia in pediatric patients with type 1 diabetes mellitus.
        Arch Pediatr Adolesc Med. 2006; 160: 573-577
        • Robertson K.
        • Adolfsson P.
        • Riddell M.
        • Scheiner G.
        • Hanas R.
        Exercise in children and adolescents with diabetes.
        Pediatr Diabetes. 2009; 10: 154-168
        • Williams B.K.
        • Guelfi K.J.
        • Jones T.W.
        • Davis E.A.
        Lower cardiorespiratory fitness in children with Type 1 diabetes.
        Diabet Med. 2011; 28: 1005-1007
        • Bernardini A.L.
        • Vanelli M.
        • Chiari G.
        • Iovane B.
        • Gelmetti C.
        • Vitale R.
        • et al.
        Adherence to physical activity in young people with Type 1 diabetes.
        Acta Biomed. 2004; 75: 153-157
        • Schweiger B.
        • Klingensmith G.
        • Snell-Bergeon J.K.
        Physical activity in adolescent females with type 1 diabetes.
        Int J Pediatr. 2010; 2010: 328318
        • Salvatoni A.
        • Cardani R.
        • Biasoli R.
        • Salmaso M.
        • De Paoli A.
        • Nespoli L.
        Physical activity and diabetes.
        Acta Biomed. 2005; 76: 85-88
        • Michaliszyn S.F.
        • Faulkner M.S.
        Physical activity and sedentary behaviour in adolescents with type 1 diabetes.
        Res Nurs Health. 2010; 33: 441-449
        • Valerio G.
        • Spagnuolo M.I.
        • Lombardi F.
        • Spadaro R.
        • Siano M.
        • Franzese A.
        Physical activity and sports participation in children and adolescents with type 1 diabetes mellitus.
        Nutr Metab Cardiovasc Dis. 2005; 17: 376-382
        • Zoppini G.
        • Carlini M.
        • Muggeo M.
        Self-reported exercise and quality of life in young type 1 diabetic subjects.
        Diabetes Nutr Metab. 2003; 16: 77-80
        • Sideraviciute S.
        • Gailiuniene A.
        • Visagurskiene K.
        • Vizabaraite D.
        The effect of long-term swimming program on glycemia control in 14–19-year aged healthy girls and girls with type 1 diabetes mellitus.
        Medicina (Kaunas). 2006; 42: 513-518
        • Roberts L.
        • Jones T.W.
        • Fournier P.A.
        Exercise training and glycemic control in adolescents with poorly controlled type 1 diabetes mellitus.
        J Pediatr Endocrinol Metab. 2002; 15: 621-627
        • Särnblad S.
        • Ekelund U.
        • Åman J.
        Physical activity and energy intake in adolescent girls with Type 1 diabetes.
        Diabet Med. 2005; 22: 893-899
        • Åman J.
        • Skinner T.C.
        • De Beaufort C.E.
        • Swift P.G.F.
        • Aanstoot H.-J.
        • Cameron F.
        Associations between physical activity, sedentary behaviour, and glycemic control in a large cohort of adolescents with type 1 diabetes: the Hvidoere Study Group on Childhood Diabetes.
        Pediatr Diabetes. 2009; 10: 234-239
        • Edmunds S.
        • Roche D.
        • Stratton G.
        Levels and patterns of physical activity in children and adolescents with type 1 diabetes and associated metabolic and physiologic health outcomes.
        J Phys Act Health. 2010; 7: 68-77
        • Wallberg-Henriksson H.
        • Gunnarsson R.
        • Henriksson J.
        • Defronzo R.
        • Felig P.
        • Östman J.
        • et al.
        Increased peripheral insulin sensitivity and muscle mitochondrial enzymes but unchanged blood glucose control in type 1 diabetics after physical training.
        Diabetes. 1982; 31: 1044-1050
        • Raile K.
        • Kapellen T.
        • Schweiger A.
        • Hunkert F.
        • Nietzschmann U.
        • Dost A.
        • et al.
        Physical activity and competitive sports in children and adolescents with type 1 diabetes.
        Diabetes Care. 1999; 22: 1904-1905
        • Lehman R.
        • Kaplan V.
        • Bingisser R.
        • Bloch K.E.
        • Spinas G.A.
        Impact of physical activity on cardiovascular risk factors in IDDM.
        Diabetes Care. 1997; 20: 1603-1611
        • The DCCT Research Group
        Effect of intensive diabetes treatment on the development and progression of long-term complications in adolescents with insulin-dependent diabetes mellitus: Diabetes Control and Complications Trial.
        J Pediatr. 1994; 125: 177-188
        • Samuelsson U.
        • SWEDIABKIDS
        National quality registry for diabetes in children 0–18 years.
        Diabetes Center, Gothenburg, Sweden [registry online]2009 (available at https://www.ndr.nu/ndr2)
      1. Swedish association of local authorities and regions. Available at https://english.skl.se/ [accessed 10.1.12].

        • Jeppsson J.O.
        • Jerntorp P.
        • Sundkvist G.
        • Englund H.
        • Nylund V.
        Measurement of hemoglobin A1c by a new liquid-chromatographic assay: methodology, clinical utility, and relation to glucose tolerance evaluated.
        Clin Chem. 1986; 32: 1867-1872
        • Hanas R.
        • John G.
        2010 consensus statement on the worldwide standardization of the hemoglobin A1C measurement.
        Diabetes Care. 2010; 33: 1903-1904
        • Örtqvist E.
        • Forsander G.
        • Sjöblad S.
        Diabetesmottagningens organisation.
        in: Sjöblad S. Barn-och ungdomsdiabetes. 2nd ed. Lund, Studentlitteratur2008
        • Karlberg J.
        • Luo Z.C.
        • Albertsson-Wikland K.
        Body mass index reference values (mean and SD) for Swedish children.
        Acta Paediatr. 2001; 90: 1427-1434
        • Currie C.
        • Hurrelman K.
        • Settertobulte W.
        • Smith R.
        • Todd J.
        Health and behaviour among young people: Health Behaviour in School aged children: a WHO Cross-National Study (HBSC) international report.
        WHO Regional Office for Europe, Denmark2000
        • Gopenath B.
        • Hardy L.L.
        • Baur L.A.
        • Burlutsky G.
        • Michell P.
        Physical activity and sedentary behaviors and health-related quality of life in adolescents.
        Pediatrics. 2012; 130: 167-174
        • Ekelund U.
        • Tomkinson G.R.
        • Armstrong N.
        What proportion of youth are physically active? Measurement issues, levels and recent time trends.
        Br J Sports Med. 2011; 45: 859-865
        • Miller K.M.
        • Beck R.W.
        • Bergenstal R.M.
        • Goland R.S.
        • Haller M.J.
        • McGill J.B.
        • et al.
        Evidence of a strong association between frequency of self-monitoring of blood glucose and hemoglobin A1C levels in T1D exchange clinic registry participants.
        Diabetes Care. 2013; ([Epub ahead of print])