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Is exercise a therapeutic tool for improvement of cardiovascular risk factors in adolescents with type 1 diabetes mellitus? A randomised controlled trial
Salem MA, Aboelasrar MA, Elbarbary NS, Elhilaly RA, Refaat YM
Diabetology & Metabolic Syndrome 2010 Jul 11;2(47):Epub
clinical trial
4/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Type 1 diabetes mellitus (T1DM) is associated with a high risk for early atherosclerotic complications especially risk of coronary heart disease. OBJECTIVE: To evaluate the impact of six months exercise prgram on glycemic control, plasma lipids values, blood pressure, severity and frequency of hypoglycemia, anthropometric measurements and insulin dose in a sample of adolescents with T1DM. RESEARCH DESIGN AND METHODS: A total of 196 type 1 diabetic patients participated in the study. They were classified into three groups: group (A) did not join the exercise program(n = 48), group (B) attended the exercise sessions once/week (n = 75), group (C) attended the exercise sessions three times/week (n = 73). Studied parameters were evaluated before and six months after exercise programe. RESULTS: Exercise improved glycemic control by reducing HbA1c values in exercise groups (p = 0.03, p = 0.01 respectively) and no change in those who were not physically active (p = 0.2). Higher levels of HbA1c were associated with higher levels of cholesterol, LDL-c, and triglycerides (p = 0.000 each). In both groups, B and C, frequent exercise improved dyslipidemia and reduced insulin requirements significantly (p = 0.00 both), as well as a reduction in BMI (p = 0.05, p = 0.00 respectively) and waist circumference (p = 0.02, p = 0.00 respectively). The frequency of hypoglycemic attacks were not statistically different between the control group and both intervention groups (4.7 +/- 3.56 and 4.82 +/- 4.23, p = 0.888 respectively). Reduction of blood pressure was statistically insignificant apart from the diastolic blood presure in group C (p = 0.04). CONCLUSION: Exercise is an indispensable component in the medical treatment of patients with T1DM as it improves glycemic control and decreases cardiovascular risk factors among them.

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