Associations between physical activity, sedentary behavior, and glycemic control in a large cohort of adolescents with type 1 diabetes: the Hvidoere Study Group on Childhood Diabetes

Abstract

Background: The Hvidoere Study Group on Childhood Diabetes has demonstrated persistent differences in metabolic outcomes between pediatric diabetes centers. These differences cannot be accounted for by differences in demographic, medical, or treatment variables. Therefore, we sought to explore whether differences in physical activity or sedentary behavior could explain the variation in metabolic outcomes between centers. Methods: An observational cross‐sectional international study in 21 centers, with demographic and clinical data obtained by questionnaire from participants. Hemoglobin A1c (HbA1c) levels were assayed in one central laboratory. All individuals with diabetes aged 11–18 yr (49.4% female), with duration of diabetes of at least 1 yr, were invited to participate. Individuals completed a self‐reported measure of quality of life (Diabetes Quality of Life ‐ Short Form [DQOL‐SF]), with well‐being and leisure time activity assessed using measures developed by Health Behaviour in School Children WHO Project. Results: Older participants (p < 0.001) and females (p < 0.001) reported less physical activity. Physical activity was associated with positive health perception (p < 0.001) but not with glycemic control, body mass index, frequency of hypoglycemia, or diabetic ketoacidosis. The more time spent on the computer (r = 0.06; p < 0.05) and less time spent doing school homework (r = −0.09; p < 0.001) were associated with higher HbA1c. Between centers, there were significant differences in reported physical activity (p < 0.001) and sedentary behavior (p < 0.001), but these differences did not account for center differences in metabolic control. Conclusions: Physical activity is strongly associated with psychological well‐being but has weak associations with metabolic control. Leisure time activity is associated with individual differences in HbA1c but not with intercenter differences.

Physical Activity and Type 1 Diabetes

“…3 Moreover, overall glycemic control (measured with glycated hemoglobin, or A1C, levels) with exercise has shown mixed results in T1D studies, with some demonstrating benefits [5][6][7] and others no improvement in A1C following aerobic or resistance training. 8,9 For overall glycemic control to be enhanced, individuals with T1D are required to skillfully balance insulin dosing and food intake to maintain blood glucose levels in a more normal range before, during, and after exercise. [10][11][12][13] Although many obstacles to safe and effective exercise participation remain, present and future technologies should assist more people with T1D to become and remain physically active to improve their health and reduce the negative impact of diabetes on participation in competitive sports and activities.…”

Physical Activity Levels of Adolescents with Type 1 Diabetes Physical Activity in T1D

“…Aman and colleagues (1) found that a reduction of sedentary activities through an increase in physical activity was associated with improved glycemic control and reduced levels of HbA1c. Hence, it is important to diagnose the physical activity level and cardiorespiratory fitness of adolescents with T1D, once the engagement in regular physical activities is a part of their treatment.…”

Increase in physical activity is associated with lower HbA1c levels in children and adolescents with type 1 diabetes: Results from a cross-sectional study based on the Swedish pediatric diabetes quality registry (SWEDIABKIDS)

“…The definition of at least 30 minutes of physical activity leading to breathlessness has been used in The Health Behaviour in School-aged Children Questionnaires by WHO in healthy children conducted in 3-year cycles in over 30 countries (30) and by the international Hvidoere Study Group on Childhood Diabetes (18) We have limited our material to include data from 2010-2011 only. Within that time period, SWEDIABKIDS contains data on 7,144 children and adolescents, 7-18 years old, with type 1 diabetes and a total of 43,612 visits.…”

“…Several studies have focused on the correlation between physical activity and HbA1c. Some have succeeded in showing a significant HbA1c-lowering effect of physical activity (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15), whereas others have failed do so (16)(17)(18)(19)(20)(21)(22). HbA1c is a main variable in pediatric diabetes care.…”