Physical Fitness in Children with Type 1 Diabetes Measured with Six-Minute Walk Test

Abstract

Aim/Hypothesis. To examine whether children with DMT1 are less physically fit than healthy children and to assess whether an elevated level of HbA1c was associated with decreased physical fitness among children with diabetes. Methods. The study was conducted using case-control methodology. The cases were 100 children with T1DM, 7–17,9 years. Study subjects underwent a 6MWT, where distance measured, heart rate, and oxygen saturation was recorded. Results. Results of the 6MWT for children with T1DM and controls were 601.3 ± 86.1 meters versus 672.1 ± 60.6 meters, respectively (P < 0.001). The cases were divided into two subgroups, one with HbA1c levels >8% and one with HbA1c <8%. Results for both groups were inferior to the controls (P < 0.001). The posttest pulse rate in all subjects was higher than the pretest pulse rate (P < 0.001). Pulse oxygen levels were lower than controls at the pretest measurement (P < 0.001), and for both cases and controls, pulse oxygen levels decreased after test (P = 0.004). However, the change in oxygen saturation did not differ between the groups (P = 0.332). Conclusions. Children with T1D are less fit than matched controls. The level of HbA1c did not affect the physical fitness of children with T1D.

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

“…However, three studies found no association between PA and glycemic control (Kalweit, Briers, & Olorunju, ; Keel et al., ; Mosso et al., ). For blood glucose regulation, in the case‐control study with 200 adolescents who were instructed to cross the maximum distance in meters following the 6‐min walk test, a positive effect of PA on blood glucose without increasing the risk for hypoglycemia was noted (Jegdic et al., ; Metcalf et al., ). Three cross‐sectional studies observed a significant positive association between reported PA and HDLs and a significant negative association with LDLs (Heyman et al., ; Mohammed et al., ; Parthasarathy et al., ).…”

“…Eight observational studies were identified reporting on the association between PA and adiposity. All of the studies but one (Jegdic, Roncevic, & Skrabic, 2013) examined the changes in adiposity measures in response to habitual PA, which was defined as those daily regular activities that require the use of large muscle groups, including walking, running, gardening, and cycling. The length of reported PA in each study ranged from a single session of 6 min of fast walking (Jegdic et al, 2013) to 7 days (Beraki et al, 2014;Cuenca-García et al, 2012).…”

Can a simple test of functional capacity add to the clinical assessment of diabetes?

“…A study conducted by Jegdic et al . [14] found that children with Type 1 diabetes walked 71 m less far (601 m vs. 672 m) than those without diabetes, and the authors concluded that children with Type 1 diabetes were less physically fit than matched healthy control subjects. In another study by Ingle et al .…”

“…Previous clinical and observational studies have reported differences in 6-min walk distance between adults with diabetes and healthy control subjects (Table 1) [14-17]; however, in these studies, the samples of adults with diabetes have been confounded by comorbidities [14,15] or subpopulations [17] and these studies did not compare 6-min walk distance between adults with both complicated and non-complicated diabetes, with that of healthy adults. One study by Latiri et al .…”

Valores de referencia del test de marcha en 6 minutos para niños y adolescentes sanos colombianos de 7 a 17 años de edad

“…Existe evidencia científica que permite recomendar esta prueba tanto en niños sanos como en niños con diferentes patologías, incluyendo las enfermedades de tipo neuromuscular y articular al cumplir criterios de confiabilidad y validez 5 . Se han publicado diferentes estudios: en adultos sanos, para establecer valores de referencia normales, como los realizados por Enright P. en 1998 6 ; en niños sanos, diferentes estudios entre los cuales se tienen los realizados en China 7 , Brasil 8 , Chile 5 , Suiza 9 y Austria, 10 relacionando índice de masa corporal y test de marcha en 6 minutos( 11 ; en pacientes con peso normal y sobrepeso 12 ; en niños y adolescentes con fibrosis quística 13 ; también se han realizado estudios implementando esta prueba en pacientes con bronquiolitis obliterante 14 , en patología congénita cardiaca 15 , en asma 16 , diabetes mellitus 17 , obesidad 18 y enfermedad renal crónica 19 , en enfermedades neuromusculares como la enfermedad de Pompe( 20 ) y distrofia muscular de Duchenne. 21 A pesar de los múltiples estudios existentes a nivel mundial, esta prueba clínica continúa siendo de poca aplicación en población pediátrica, posiblemente debido a la falta de información y difusión respecto a los beneficios y facilidad de aplicación tanto en niños sanos como con algún tipo de enfermedad; con el objeto de valorar la tolerancia al ejercicio fí-sico y de manera indirecta poder valorar el consumo de oxígeno, es decir, la capacidad aeróbica, así mismo se ha presentado dificultad para obtener valores de referencia en esta población.…”