Exercise in children and adolescents with diabetes

Robertson, Kenneth; Riddell, Michael C.; Guinhouya, Benjamin C.; Adolfsson, Peter; Hanås, Ragnar

doi:10.1111/pedi.12176

Cited by 108 publications

(81 citation statements)

References 150 publications

(190 reference statements)

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“…Glucagon is released in response to exercise to provide energy by stimulating glycogenolysis and gluconeogenesis to prevent hypoglycemia and maintain homeostasis (15). The complex feedback interactions between insulin, glucagon, and other counter-regulatory hormones (catecholamines, growth hormone, cortisol) maintain a balance between glucose utilization and glucose production (3,16). Glucose metabolism by muscle is also highly regulated.…”

Section: Physiology Of Exercisementioning

confidence: 99%

“…The American Academy of Pediatrics (AAP) recommends that all children, including those with diabetes mellitus engage in at least 60 minutes of daily physical activity starting at 5 years of age (2). Exercise, insulin, and dietary management were described as three components important for management of blood glucose regulation by Joslin as early as the 1950s (3). Regular physical activity has been shown to improve cardiovascular complications (hypertension and dyslipidemia) and improve insulin sensitivity, leading to an improvement in glycemic control in these patients (4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

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Management of diabetes mellitus in children and adolescents: engaging in physical activity

Nadella¹,

Indyk²,

Kamboj³

2017

Transl. Pediatr.

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Regular physical activity is an important component in the management of both type 1 and type 2 diabetes mellitus (T1DM and T2DM), as it has the potential to improve glycemic control, delay cardiovascular complications, and increase overall well-being. Unfortunately, many children and adolescents with diabetes do not partake in regular exercise and physical activity for multiple reasons. This review identifies the barriers to participation from the aspect of the patient, caregiver, and the healthcare provider.The management of physical activity of children and adolescents with diabetes mellitus is unique and requires an understanding of exercise physiology and how it differs in these children and adolescents from those without the condition. These individuals are at risk for important and potentially life threatening complications including, but not limited to, severe or delayed nocturnal hypoglycemia. It is essential to identify these risks as well as, monitor and manage adjustments to carbohydrate intake and insulin dosing through basal-bolus regimen or insulin pump adjustments appropriately before, during, and after the exercise activity. This review discusses these issues and also outlines differences in management between patients with T1DM and T2DM.

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Section: Physiology Of Exercisementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Management of diabetes mellitus in children and adolescents: engaging in physical activity

Nadella¹,

Indyk²,

Kamboj³

2017

Transl. Pediatr.

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“…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.…”

Section: Introductionmentioning

confidence: 99%

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)

Beraki

Magnuson

Särnblad

et al. 2014

Diabetes Research and Clinical Practice

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“…These findings suggest that a short sprint may provide a useful approach for reducing the risk of exercise-mediated hypoglycaemia [5]. For these reasons the use of sprinting for hypoglycaemia prevention has been included in recent clinical practice guidelines published by the International Society for Pediatric and Adolescent Diabetes and the National Health and Medical Research Council of Australia [17][18][19]. However, it is our view that before advocating sprinting as a reliable tool for hypoglycaemia prevention, it is important to determine whether there are factors that could impair the glucoregulatory benefits of this type of exercise.…”

Section: Introductionmentioning

confidence: 99%

Antecedent hypoglycaemia does not diminish the glycaemia-increasing effect and glucoregulatory responses of a 10 s sprint in people with type 1 diabetes

et al. 2014

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Aims/hypothesis A 10 s sprint has been reported to provide a means to prevent acute post-exercise hypoglycaemia in young adults with type 1 diabetes because of its glycaemia-raising effect, but it is unclear whether this effect is impaired by antecedent hypoglycaemia. The purpose of this study was to investigate whether antecedent hypoglycaemia impairs the glycaemia-raising effect of a 10 s sprint in individuals with type 1 diabetes. Methods Eight individuals underwent a hyperinsulinaemichypoglycaemic or hyperinsulinaemic-euglycaemic clamp on two separate mornings. Thereafter, the participants underwent a basal insulin-euglycaemic clamp before performing a 10 s sprint on a cycle ergometer. The levels of blood glucose and glucoregulatory hormones and rates of glucose appearance (Ra) and disappearance (Rd) were compared between conditions. Results During the morning clamps, blood glucose levels were significantly different between conditions of hypoglycaemia (2.8 ± 0.1 mmol/l) and euglycaemia (5.4 ± 0.2 mmol/l; p < 0.001). Mean glycaemia prior to sprinting was similar (5.6 ± 0.4 and 5.5± 0.3 mmol/l for hypoglycaemic and euglycaemic conditions, respectively; p=0.83). In response to the afternoon sprint, the pattern of increase in blood glucose levels did not differ between conditions, reaching similar maximal levels 45 min after exercise (6.5±0.4 and 6.6±0.3 mmol/l, respectively; p= 0.43). The early post-exercise patterns in glucose Ra and Rd and increases in plasma adrenaline (epinephrine), growth hormone and cortisol levels did not differ between conditions. Conclusions/interpretation Hypoglycaemia in the morning does not diminish the glycaemia-raising effect of an afternoon 10 s sprint in young adults with type 1 diabetes, suggesting that sprinting is a useful strategy for opposing hypoglycaemia, regardless of prior hypoglycaemia.

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Exercise in children and adolescents with diabetes

Cited by 108 publications

References 150 publications

Management of diabetes mellitus in children and adolescents: engaging in physical activity

Management of diabetes mellitus in children and adolescents: engaging in physical activity

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)

Antecedent hypoglycaemia does not diminish the glycaemia-increasing effect and glucoregulatory responses of a 10 s sprint in people with type 1 diabetes

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