Effect of low to moderate intensity walking and cycling on glycaemic and metabolic control in type 1 diabetes mellitus adolescent males: A randomized controlled trial

Abstract

BACKGROUND: Type 1 diabetes mellitus (T1DM) is characterized by an autoimmune destruction of pancreatic beta cells, i.e., the immune system destroys the special cells that make and secrete insulin. OBJECTIVE: To evaluate the effect of 12 weeks exercise programme on glycaemic and metabolic control in T1DM adolescents. METHODS: Twenty-four T1DM adolescent males (12-16 y) were randomised into an exercise (n = 12) and control group (n = 12). Twelve weeks of exercise programme was administered to the exercise group. Two patients, one in each group discontinued training. Training intensity was 40-60% of maximum heart rate for a duration 60 min, 3 times a week. RESULTS: No significant improvement was seen in HbA1c (P = 0.598), low density lipoprotein (P = 0.264), high density lipoprotein (P = 0.276) and triglycerides (P = 0.490) in the exercise group but significant improvement was observed in insulin dose (P = 0.000) and total cholesterol (P = 0.035). CONCLUSIONS: Twelve weeks of closely supervised exercise programme enhanced reduction in insulin dose and lowered the total cholesterol T1DM adolescent male and could be recommended as a part of the management of T1DM.

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

“…The five remaining studies yielded relatively consistent results about glycemic control and PA. Regardless of type, duration, and frequency of the exercise, four studies (Gusso et al, 2012;Nguyen et al, 2015;Shin et al, 2014;Tomar et al, 2014) showed no significant associations between PA and HbA1c. In the fifth study by Carabott Pawley et al (2016), the results showed stabilized levels of HbA1c in the experimental group compared with a 0.6% increase in the control group after the exercise program; however, the results were statistically insignificant (p > .05).…”

“…The five remaining studies yielded relatively consistent results about glycemic control and PA. Regardless of type, duration, and frequency of the exercise, four studies (Gusso et al., ; Nguyen et al., ; Shin et al., ; Tomar et al., ) showed no significant associations between PA and HbA1c. In the fifth study by Carabott Pawley et al.…”

“…For lipid profile effects, participants who completed the exercise sessions in the RCT by Tomar et al. () demonstrated a significant reduction in TC levels ( p = .035) without any significant difference in LDLs, HDLs, and TG compared to the control group. The quasi‐experimental study (Shin et al., ) yielded consistent results on TC and HDLs after exercise.…”

“…It is notable that cardiorespiratory fitness can be maintained with light-to moderate-intensity exercise and good glycemic control in children and adolescents with T1D. Regarding insulin dosage, Tomar et al (2014) conducted an RCT using a closely supervised aerobic exercise program of walking and cycling (three times per week for 12 consecutive weeks) on 24 male adolescents with T1D. After 12 weeks of exercise, the study showed a significant reduction in daily insulin dose in the exercise group (p = .00) compared with their peers in the control group.…”

“…All studies provided data on the duration of the exercise sessions. The number of sessions ranged from one time per day (Adolfsson, Nilsson, Albertsson, & Lindblad, 2012;Carabott Pawley et al, 2016;Gusso et al, 2012) to three times per week (Shin et al, 2014;Tomar, Hamdan, & Al-Qahtani, 2014), and the mean duration of follow-up after enrollment ranged from 3 days (Adolfsson et al, 2012) to 9 months (Maggio et al, 2012). All studies included data on the duration of the exercise sessions and included advice to exercise for at least 10 min per session.…”