Fitness and physical activity in youth with type 1 diabetes mellitus in good or poor glycemic control.

Pediatric Diabetes (Impact Factor: 2.13). 01/2014; DOI: 10.1111/pedi.12117
Source: PubMed

ABSTRACT Patients with type 1 diabetes mellitus (T1DM) may experience poor muscle health as a result of chronic hyperglycemia. Despite this, muscle function in children with T1DM with good or poor glycemic control has yet to be examined in detail.
To assess differences in muscle-related fitness variables in children with T1DM with good glycemic control (T1DM-G), as well as those with poor glycemic control (T1DM-P), and non-diabetic, healthy controls.
Eight children with T1DM-G [glycosylated hemoglobin (HbA1c) ≤ 7.5% for 9 months], eight children with T1DM-P (HbA1c ≥ 9.0% for 9 months), and eight healthy controls completed one exercise session.
Anaerobic and aerobic muscle functions were assessed with a maximal isometric grip strength test, a Wingate test, and an incremental continuous cycling test until exhaustion. Blood samples were collected at rest to determine HbA1c at the time of testing. Physical activity was monitored over 7 d using accelerometry.
Children with T1DM-P displayed lower peak oxygen consumption (VO2peak ) values (mL/kg/min) compared to healthy controls (T1DM-P: 33.2 ± 5.6, controls: 43.5 ± 6.3, p < 0.01), while T1DM-G (43.5 ± 6.3) had values similar to controls and T1DM-P. There was a negative relationship between VO2peak and HbA1c% (r = -0.54, p < 0.01). All groups were similar in all other fitness variables. There were no group differences in physical activity variables.
Children with T1DM-G did not display signs of impaired muscle function, while children with T1DM-P have signs of altered aerobic muscle capacity.

  • [Show abstract] [Hide abstract]
    ABSTRACT: The cardiorespiratory and metabolic responses of juvenile-onset diabetic (Dia) and nondiabetic (Con) boys to light, moderate, and maximal treadmill work were investigated. No significant differences were observed between the Dia and Con subjects in cardiorespiratory responses to maximal and submaximal work. The mean values for the Dia boys during maximal treadmill work for ventilatory volume, oxygen uptake, heart rate, and lactic acid were 91.5 L/min, 54.9 ml/kg . min, rate, and lactic acid were 91.5 L/nin, 54.9 ml/kg . min, 198 beats/min, and 7.0 mM/L, respectively. In the Dia boys, maximal-, light-, and moderate-intensity work produced significant plasma glucose decreases (P less than 0.05) of 1.64, 3.23, and 7.2 mM/L, respectively. In the Con boys, the submaximal work bouts were performed without significant change in plasma glucose levels, but glucose levels after maximal work were elevated 1.58 mM/L. Light and moderate work in both groups produced no changes in plasma triglycerides, free fatty acids, or lactic acid. However, for the Dia boys, maximal work was associated with a significant increase of 0.36 mM/L in triglycerides.
    Diabetes 01/1980; 28(12):1114-9. · 8.47 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Seventeen type I male diabetic adolescents and 17 control subjects matched for age, height, and weight were submitted to maximal exercise on a bicycle ergometer. The diabetic subjects were divided into two groups according to their degree of metabolic control using total glycosylated hemoglobin (HbA1): group 1, diabetics with HbA1 less than 8.5% (n = 9) and group 2, diabetics with HbA1 greater than 8.5% (n = 8). Oxygen uptake, pulmonary ventilation, and heart rate were recorded at rest and at maximal load. Glucose, lactate, and free fatty acids were determined in blood before and after exercise. Maximal work load and oxygen uptake were significantly lower in the two diabetic groups than in the healthy controls. An inverse relationship was observed between HbA1 concentration and the maximal work load (r = -0.63; P less than 0.01). It can be concluded that diabetic adolescents should obtain the best possible degree of metabolic control to improve their performances.
    International Journal of Sports Medicine 09/1986; 7(4):232-5. · 2.37 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: We evaluated the cardiac response to dynamic exercise in a group of otherwise healthy insulin-dependent older children and adolescents and in a nondiabetic control group by postexercise echocardiography. Both groups had similar left ventricular function at rest. After exercise we found abnormalities in the indicators of systolic function, fractional shortening (0.37 vs. 0.43) and rate-corrected velocity of circumferential fiber shortening (2.80 vs. 3.35 circumferences/s). In addition, we found an association of flattened interventricular septal motion with finger contractures in the diabetic subjects. Echocardiographic abnormalities in asymptomatic young diabetic adolescents can be elucidated by postexercise echocardiography. Postexercise echocardiography is a noninvasive procedure that can easily be done in the adolescent population and is useful for evaluating subclinical cardiomyopathy.
    Diabetes Care 05/1987; 10(3):319-23. · 8.57 Impact Factor