Impact of Exercise on Overnight Glycemic Control in Children with Type 1 Diabetes Mellitus

Tsalikian, Eva; Mauras, Nelly; Rw, Beck; Wv, Tamborlane; Kf, Janz; Hp, Chase; Wysocki, Tim; Sa, Weinzimer; Buckingham, Bruce A.; Kollman, Craig; Xing, Dongyuan; Kj, Ruedy

doi:10.1016/j.jpeds.2005.04.065

Cited by 232 publications

(62 citation statements)

References 22 publications

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“…25–27 Problem solving may have a role in engagement in exercise since it requires consideration of numerous factors including the frequency, duration, type, and intensity of exercise, the adolescent’s current metabolic control and fitness level, type, timing, and dose of insulin delivered before exercise, site of injection, and food intake relative to exercise. 28,29 Identifying ways to engage in physical activity and healthy lifestyle also has implications for weight management and prevention in adolescents with T1DM. The results of this study suggest a need for more education and support pertaining to problem solving around exercise.…”

Section: Discussionmentioning

confidence: 99%

Self-Management in Early Adolescence and Differences by Age at Diagnosis and Duration of Type 1 Diabetes

et al. 2014

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Purpose The purpose of the study was to describe the frequency of diabetes self-management activities, processes, and goals among early adolescents. In addition, differences in self-management by age at diagnosis and duration of diabetes were explored. Methods A cross-sectional design was used to analyze baseline data from 320 adolescents with T1DM enrolled in a multisite clinical trial. Participants completed questionnaires on demographic/clinical characteristics and self-management. Results There was a transitional pattern of self-management with a high frequency of diabetes care activities, problem solving, and goals and variable amounts of collaboration with parents. After controlling for therapy type and age, youth with short diabetes duration reported performing significantly more diabetes care activities than individuals with a longer duration. Individuals with short diabetes duration had more frequent communication than individuals with a longer duration, which was associated with diagnosis in adolescence. Among those diagnosed as school age children, those with short diabetes duration reported significantly more diabetes goals than those with a longer duration. Conclusions A more specific understanding of self-management may help clinicians provide more targeted education and support. Adolescents with a long duration of diabetes need additional self-management support, particularly for diabetes care activities and communication.

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Section: Discussionmentioning

confidence: 99%

Self-Management in Early Adolescence and Differences by Age at Diagnosis and Duration of Type 1 Diabetes

et al. 2014

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“…For insulin-treated patients, exercise increases the risk of hypoglycemia. This risk may either be immediate, meaning during or shortly after exercise, or delayed by 6-15 hours after activity 38,39. Alcohol consumption can cause prolonged, unexpected hypoglycemia in people with T2DM, particularly in those taking ADA 40.…”

Section: Overviewmentioning

confidence: 99%

Hypoglycemia Revisited in the Acute Care Setting

et al. 2011

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Hypoglycemia is a common finding in both daily clinical practice and acute care settings. The causes of severe hypoglycemia (SH) are multi-factorial and the major etiologies are iatrogenic, infectious diseases with sepsis and tumor or autoimmune diseases. With the advent of aggressive lowering of HbA1c values to achieve optimal glycemic control, patients are at increased risk of hypoglycemic episodes. Iatrogenic hypoglycemia can cause recurrent morbidity, sometime irreversible neurologic complications and even death, and further preclude maintenance of euglycemia over a lifetime of diabetes. Recent studies have shown that hypoglycemia is associated with adverse outcomes in many acute illnesses. In addition, hypoglycemia is associated with increased mortality among elderly and non-diabetic hospitalized patients. Clinicians should have high clinical suspicion of subtle symptoms of hypoglycemia and provide prompt treatment. Clinicians should know that hypoglycemia is associated with considerable adverse outcomes in many acute critical illnesses. In order to reduce hypoglycemia-associated morbidity and mortality, timely health education programs and close monitoring should be applied to those diabetic patients presenting to the Emergency Department with SH. ED disposition strategies should be further validated and justified to achieve balance between the benefits of euglycemia and the risks of SH. We discuss relevant issues regarding hypoglycemia in emergency and critical care settings.

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“…These findings concur with previous work by Tsalikian et al. (2005) who reported that during 60 min of MIE, 82% of participants experienced at least a 25% decrease in glucose compared to pre‐exercise. Conversely, previous research in adults with T1D showed less of a decline in blood glucose following sprint interval exercise, compared to MIE (Guelfi et al.…”

Section: Discussionmentioning

confidence: 99%

“…This increased incidence of nocturnal hypoglycemia has been demonstrated previously in children with T1D (aged 11–17 years), with 22% of participants experiencing hypoglycemia the night following 60 min of afternoon MIE (Tsalikian et al. 2005). The risk of nocturnal hypoglycemia after HIIE in youth with T1D is poorly understood, but is likely due to HIIE having greater insulin sensitizing effects than MIE (Cockcroft et al.…”

Section: Discussionmentioning

confidence: 99%

High-intensity interval exercise and glycemic control in adolescents with type one diabetes mellitus: a case study

et al. 2017

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Current physical activity guidelines for youth with type 1 diabetes (T1D) are poorly supported by empirical evidence and the optimal dose of physical activity to improve glycemic control is unknown. This case report documents the effect of acute high‐intensity interval exercise (HIIE) and moderate‐intensity exercise (MIE) on 24‐h glycemic control in three adolescents with T1D using continuous glucose monitoring. Results highlight varied individual response to exercise across the participants. In two participants both MIE and HIIE resulted in a drop in blood glucose during exercise (−38 to −42% for MIE and −21–46% in HIIE) and in one participant both MIE and HIIE resulted in increased blood glucose (+19% and + 36%, respectively). Over the 24‐h period average blood glucose was lower for all participants in the HIIE condition, and for two for the MIE condition, compared to no exercise. All three participants reported HIIE to be more enjoyable than MIE. These data show both HIIE and MIE have the potential to improve short‐term glycemic control in youth with T1D but HIIE was more enjoyable. Future work with a larger sample size is required to explore the potential for HIIE to improve health markers in youth with T1D.

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Impact of Exercise on Overnight Glycemic Control in Children with Type 1 Diabetes Mellitus

Abstract: These findings indicate that overnight hypoglycemia after exercise is common in children with T1DM and support the importance of modifying diabetes management after afternoon exercise to reduce the risk of hypoglycemia.

Cited by 232 publications

References 22 publications

Self-Management in Early Adolescence and Differences by Age at Diagnosis and Duration of Type 1 Diabetes

Self-Management in Early Adolescence and Differences by Age at Diagnosis and Duration of Type 1 Diabetes

Hypoglycemia Revisited in the Acute Care Setting

High-intensity interval exercise and glycemic control in adolescents with type one diabetes mellitus: a case study

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