INTRODUCTION: Osteoporosis is a growing health problem in patients with type 1 diabetes mellitus (T1DM). The aim of this study was to determine the effects of a 9-month weight-bearing physical activity program on bone mineral density (BMD) and bone biomarkers in T1DM compared with healthy children. METHODS: This was a randomized controlled trial including 27 diabetic and 32 healthy children (mean age 10.5 +/- 2.5 yr). Both T1DM and healthy participants were randomized to either an exercise or a control group (ie, four groups). At baseline and 9 months, total body (TB), lumbar spine (LS2 to LS4), femoral neck, and greater trochanter areal BMD (aBMD) and serum bone biomarkers (osteocalcin, type 1 collagen cross-linking) were measured. The intervention consisted of two 90-min sessions per week of weight-bearing physical activity (ball games, jumping, rope skipping, and gymnastics). RESULTS: Baseline variables were similar among groups. At 9 months, changes in TB (T1DM = 0.035 +/- 0.022 g/cm, healthy = 0.031 +/- 0.017 g/cm) and LS2 to LS4 (T1DM = 0.046 +/- 0.038 g/cm, healthy = 0.063 +/- 0.034 g/cm) aBMD were statistically significant in the intervention groups and of similar magnitude between T1DM and healthy subjects. The level of type 1 collagen cross-linking (T1DM = -0.12 +/- 0.32 ng/mL, healthy = -0.36 +/- 0.11 ng.mL) decreased in the intervention groups but was not associated with TB aBMD changes. CONCLUSIONS: Regular weight-bearing physical activity (180 min/wk, including ball games, jumping activities, and gymnastics) improves total and LS2 to LS4 bone mineral accretion in children with T1DM, in a similar magnitude to healthy subjects. We conclude that children with T1DM should be encouraged to practice regular physical activity to enhance peak bone mass and prevent osteoporosis later in life.

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