A Systematic Review of Physical Activity and Exercise on Physiological and Biochemical Outcomes in Children and Adolescents With Type 1 Diabetes

Abstract

Purpose In this systematic review we aimed to evaluate the effects of physical activity (PA) and exercise on biochemical and physiological outcomes in children and adolescents with type 1 diabetes (T1D). Design The review was conducted and reported following the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. Methods The search of literature was performed using PubMed, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, the Cochrane Library, Scopus, Medline, PsycINFO, the Nursing Reference Center, and Google Scholar. The search was limited to include peer‐reviewed articles published in English from May 2012 to May 2018 and included adolescents <19 years of age with T1D. Twenty‐seven studies met the inclusion criteria: 8 interventional and 19 observational studies. Findings Both observational and interventional studies showed considerable agreement that supervised regular moderate to vigorous physical activity (MVPA) is more effective on adiposity and cardiorespiratory fitness than habitual PA. Further, it was reported that PA of different intensities improves insulin sensitivity and decreases daily insulin dosage. Results of glycemic control were equivocal. Although observational studies reported improvement in glycemic control with PA of different intensities, most of the experimental studies revealed no significant associations. A consistent agreement among the studies revealed a considerable benefit of regular habitual PA of light to moderate intensity on blood glucose regulation and lipid profile. Conclusions The reviewed studies showed that regular MVPA was associated with several health benefits in adolescents with T1D; however, additional studies are needed to fully understand the effect of PA on health outcomes. Clinical Relevance Regular MVPA (at least 4 hr per week) with good glycemic control is a promising option for adolescents with T1D when risk management of hypoglycemia is appropriately taken.

Moving more: physical activity and its positive effects on long term conditions in children and young people

“…Importantly, several meta-analyses demonstrate that physical activity improves overall diabetes control. Glycaemic control evidenced by improvement in HbA1C is improved, particularly when the number of days and intensity of physical activity increases,43 50–52 with additional benefits including lower insulin requirements and enhanced insulin sensitivity in children and young people with T1DM 46 53 54…”

Filling gaps in type 1 diabetes and exercise research: a scoping review and priority-setting project

“…This is the first scoping review of exercise randomized trials for individuals with T1D designed to determine if patient engagement exists in exercise and T1D literature. This topic was not addressed in recent systematic reviews of exercise training and health outcomes in people with T1D 41–43. We found that exercise randomized trials published or being delivered for individuals with T1D did not focus on stakeholder engagement.…”

Physioprophylaxis of type 1 diabetes in children using physical exercise

“…Meta-analyses by Absil et al, Aljawarneh et al, and Tonoli et al confirmed the positive effects of aerobic training, while emphasizing the ambiguous influence of strength training on glycaemia of patients with type 1 diabetes [32][33][34]. Yardley et al indicated a smaller initial decrease in blood glucose levels during strength training compared to aerobic training [35].…”