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Exercise improves disease severity biomarkers in type 1 diabetes

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January 4, 2018

Results from a systematic review and meta-analysis show that patients with type 1 diabetes who exercised experienced improvement in several different markers of disease severity.

Neil Smart
Neil Smart

“This pooled data analysis revealed that relatively few exercise training studies in people with type 1 diabetes have been published in comparison to those with type 2 diabetes,” Neil A. Smart, MD, professor of exercise and sports science at the school of science and technology at the University of New England, Armidale, Australia, told Endocrine Today.Moreover, the existing type 1 studies vary greatly in terms of the exercise programming, age of participants (adults vs. children) and confounders within study designs.”

The researchers used multiple databases, including MEDLINE, the Cochrane Controlled Trials Registry, SPORTDiscus, the Science Citation Index and CINAHL to identify clinical trials of exercise in patients with type 1 diabetes.

Adults with type 1 diabetes demonstrated significant improvements in BMI (mean difference, –0.39 kg/m2; 95% CI, –0.75 to –0.02) and body mass (mean difference, –2.20 kg; 95% CI, –3.79 to –0.61), as well as peak oxygen intake (mean difference, 4.08 mL/kg/min; 95% CI, 2.18-5.98) and LDL cholesterol (mean difference, –0.21 mmol/L; 95% CI, –0.33 to –0.08), the researchers reported.

Children showed significant improvements in other areas, Smart and colleagues wrote, including insulin dose (mean difference, –0.23; IU/kg; 95% CI, –0.37 to 0.09), waist circumference (mean difference, –5.4 cm; 95% CI, –8.45 to –2.35), triglycerides (mean difference, –0.21 mmol/L; 95% CI, –0.42 to –0.01) and LDL cholesterol (mean difference, –0.31 mmol/L; 95% CI, –0.55 to –0.06).

Smart and colleagues reported no changes in resting heart rate, resting systolic blood pressure, HDL, HbA1c or fasting blood glucose in either children or adults.

“Exercise training appears to confer some benefits in terms of medication use and cardiovascular disease risk factors, but does not exert much effect on glucose metabolism,” Smart said. “As type 1 diabetes is not necessarily a disease caused by an ‘excess lifestyle,’ future work might focus on low-volume, vigorous to high-intensity exercise interventions that optimize GLUT 4 transporter influence. Future work might also benefit from researchers within this field coming together to standardize study design and reporting with the goal of minimizing variation in the parameters.” . – by Andy Polhamus

Disclosures: The authors report no relevant financial disclosures.

itj+ Infographic

Exercise was associated with improvement in disease severity biomarkers in adults and children with type 1 diabetes