Type 1 diabetes does not impair the physical capacity of non-sedentary adolescents

Abstract

BackgroundType 1 diabetes patients have a higher risk of developing hypoglycemia or hyperglycemia during physical activity, which may compromise their safety during exercise but results regarding the exercise capacity of patients with type 1 DM when compared to control subjects have been contradictory.AimTo evaluate if type 1 diabetes affects the capacity of adolescents to exercise.MethodsThe study enrolled 37 adolescents in stage 2–4 of the Tanner scale, aged from 10 to 14 years, 21 with type 1 diabetes and 16 without any chronic diseases. All subjects performed an incremental submaximal exercise test in a cycle ergometer. At the end of every test stage, glycemia and blood lactate levels were measured. During the test, heart rate was monitored and the Borg rating of perceived exertion (RPE) was used to assess fatigue.ResultsThe two groups displayed no significant differences in anthropometric variables. The response to exercise, as evaluated by Borg RPE (p = 0.829), maximum oxygen uptake (VO2max) (p = 0.977), heart rate (p = 0.998), maximum load (p = 0.977), absolute load at lactate threshold (p = 0.377) and relative load at lactate threshold (p = 0.282), was also similar between the control and the type 1 diabetes group. Finally, there were no significant correlations between HbA1c levels, VO2max, duration of disease and pre-test glycemia levels.ConclusionsWe detected no significant differences in lactate threshold, VO2max and heart rate during exercise between healthy adolescents and non-sedentary adolescents with type I diabetes, indicating that both groups had similar physical fitness and, therefore, that type 1 diabetes is not an obstacle for physical activity. This study was approved by the ethical committee of the Hospital Israelita Albert Einstein (Ethical Committee Number: 53638416.9.0000.0071) and free and informed consent was obtained from all participants and their legal representatives.

Assessment of Exercise Capacity in Children with Type 1 Diabetes in the Cooper Running Test

“…Our observation is in line with the aforementioned studies [22,23]. In our study group we did not find any relationship between HbA1c concentration and Cooper test results, which is consistent with the findings of Nascimiento et al [22]. On the other hand, Nguyen et al demonstrated that children with poor glycemic control (HbA1c > 74.9 mmol/mol for > 9months) displayed lower maximum VO2 peak than healthy controls [23], while those with HbA1c < 58 mmol/mol were not different from healthy peers.…”

“…We demonstrated that children with T1DM who participated in the present study, all with good or suboptimal glycemic control, displayed fitness level similar to that of the general population of their peers. Our observation is in line with the aforementioned studies [22,23]. In our study group we did not find any relationship between HbA1c concentration and Cooper test results, which is consistent with the findings of Nascimiento et al [22].…”

“…Some of them revealed worse exercise capacity in children with T1DM [16,32], others failed to find any disparities [1,13,20,22,29]. In most of these studies children's oxygen uptake during incremental progressive cycling test was assessed, either by direct measurement of peak oxygen uptake (VO2peak) with breath-by-breath gas exchange [1,16,20,23,29] monitoring or by estimation of maximal oxygen uptake (VO2max) based on maximal workload [22]. While this method is perceived a golden standard, it imposes certain limitations that may affect measurements.…”

“…To date, a limited number of studies analyzed physical capabilities of children with T1DM [16,20,22,23,29,32,33]. Most of them were performed in laboratory settings which do not reflect real-life school or sport club conditions where school children and students are commonly tested.…”

Differences in Physiological Responses to Cardiopulmonary Exercise Testing in Adults With and Without Type 1 Diabetes: A Pooled Analysis

“…Furthermore, significant relationships between physiological parameters of exercise performance and anthropometric variables for healthy controls are shown in Table 3. (24).…”