BackgroundType 1 diabetes mellitus (T1DM) is associated with a high risk for early atherosclerotic complications especially risk of coronary heart disease.ObjectiveTo 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 methodsA 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.ResultsExercise 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).ConclusionExercise is an indispensable component in the medical treatment of patients with T1DM as it improves glycemic control and decreases cardiovascular risk factors among them.

No abstract

ProcedureThe study included 60 children and adolescents with T1DM recruited from Diabetes Clinic, Ain-shams University. Controls consisted of 40 healthy children and adolescents matched in age, gender, BMI and pubertal staging to the study group. A written consent was taken from the parents of both patients and controls. Patients known to take medication that affect bone metabolism was excluded e.g. (Ca, vitamin -D or steroids). All patients presented in the study had normal serum vitamin D level.Demographic and disease related data were taken, including; age of onset and duration of diabetes, regimen, type and dose of insulin used, history of chronic bone-aches or previous bone fracture on minor trauma and the recorded full dietary intake for 3 days prior to the study [4] to determine the mean dietary zinc intake.Physical examination including anthropometric measurements and pubertal staging [5] were recorded. Patients with tanner stage 1 are defined as prepubertal and those with tanner stage 2 or above are considered pubertal. Laboratory investigations included were; measurements of the mean fasting and postprandial blood glucose of the last month (at least 30 readings), the mean HbA1c of the last year measurements (4 reading), fasting serum osteocalcin measurement via ELISA and serum zinc assay by direct colorimetric method. Statistical analysisThe data were processed on computer using SPSS (version 15). Chi-Square test was used to test the association variables for categorical data. Student's t-test was used to assess the difference between two independent samples. Correlation analysis was used to assess the association between two variables. Linear Regression analysis: was used to search for a panel (independent parameters) that can predict the target parameter (osteocalcin). P-values less than 0.05 were considered significant, while at 0.01 or 0.001 were considered highly significant ResultsThis study was conducted on 60 children and adolescents with T1DM. They were 25 males and 35 females with a mean age of 12.23± 4.26 years. Patients and controls were well matching regarding demographic characteristics, anthropometric measurements and pubertal staging. Serum osteocalcin was significantly lower in diabetic patients compared to control group (P= 0.00), While there was no significant difference regarding zinc dietary intake and serum zinc (P> 0.05) ( Table 1). Serum osteocalcin was significantly higher in prepubertal patients compared to pubertal patients (P= 0.004), while there was no statistical difference in serum zinc and dietary zinc intake as regards pubertal or prepubertal patients (P> 0.05) ( Table 2). Serum osteocalcin was lower in patients with HbA1c ≥7.5 compared to patients with HbA1c < 7.5, (P= 0.014). Serum zinc and dietary zinc intake was significantly lower in patients with history of chronic bone aches (P< 0.05), Serum osteocalcin was also lower in patients who had a history of chronic bone aches but of no statistical significant value (P>0.05) ( Table 3). Daily dietary zinc intake was pos...

No abstract