What are the health benefits of physical activity in type 1 diabetes mellitus? A literature review

Abstract

Physical activity improves well-being and reduces the risk of heart disease, cancer and type 2 diabetes mellitus in the general population. In individuals with established type 2 diabetes, physical activity improves glucose and lipid levels, reduces weight and improves insulin resistance. In type 1 diabetes mellitus, however, the benefits of physical activity are less clear. There is poor evidence for a beneficial effect of physical activity on glycaemic control and microvascular complications, and significant risk of harm through hypoglycaemia. Here we review the literature relating to physical activity and health in type 1 diabetes. We examine its effect on a number of outcomes, including glycaemic control, lipids, blood pressure, diabetic complications, well-being and overall mortality. We conclude that whilst there is sufficient evidence to recommend physical activity in the management of type 1 diabetes, it is still unclear as to what form, duration and intensity should be recommended and whether there is benefit for many of the outcomes examined.

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)

“…1 The β-coefficient indicates the mean unit the HbA1c level declines when mean PA increases with one unit. 2 Percentage of the total variability of HbA1c explained by all factors in each model. Psyical activity groups, girls Figure legend Abbreviations: HbA1c, glycosylated hemoglobin A1c; PA, frequency of physical activity per week; PA0, none, PA1, less than once a week, PA2, 1-2 times per week, PA3, 3-5 times per week, and PA4, every day.…”

“…Physical activity has an important part to play in the prevention of diabetes complications and in the management of type 1 and type 2 diabetes mellitus (1,2). To attain desired health outcomes, school-age youth are recommended to engage in moderate to vigorous physical activity 60 minutes or more per day (3).…”

“…Hypoglycemia and smoking habits were tested on dichotomous scale (yes/no) due to small number. 2 Data missing on insulin method for 78 (2%) patients with PA known and 47 (3%) patients with PA unknown.…”

Interval Training Is Insufficient to Attenuate Metabolic Disturbances in Diabetic Rats

“…Regular exercise is associated with significant health benefits for patients with type 1 diabetes, including increased cardiorespiratory fitness, decreased insulin requirements, improved endothelial function, decreased serum cholesterol, and increased vascular health along with improvements in body composition and quality of life 5 . Clinical practice guidelines recommend 150 min of moderate (50-70% of person's maximum heart rate) to vigorous (>70% of person's maximum heart rate) physical activity weekly for adults with T1D 6 .…”

Autonomic dysfunction associated with Type 1 diabetes: a role for fitness?

“…Along with individualized diet and insulin regimens prescribed for patients with T1DM, exercise has long been considered a key component to diabetes management [2]. Along with the improvements associated with cardiorespiratory health and reductions in the risk for chronic disease, exercise training has clearly been shown to improve ANS function [6].…”