Abstract
To identify the level of physical activity and glycemic variability of adolescents with type 1 diabetes mellitus and to compare glycemic variability on days with different amounts of moderate to vigorous physical activity (MVPA). A sample of 34 subjects aged 10 to 15 years, 18 (52.94%) female; age: 13.04 ± 1.94; HbA1c: 9.76 ± 1.51. Physical activity was measured by wGT3X accelerometer. The glucose data were obtained using continuous glucose monitoring, and the following glycemic variability measures were calculated: standard deviation (SD), low blood glucose index (LBGI), high blood glucose index (HBGI), mean amplitude of glycemic excursions (MAGE), glycemic risk assessment in diabetes equation (GRADE) and coefficient of variation (CV). The most and least active days (the days with greater and lesser time dedicated to physical activities of moderate to vigorous intensity, respectively) were identified. In addition, based on the whole period of accelerometer use, daily means of time spent in MVPA were identified among participants, who were then divided into three groups: up to 100 minutes; from 101 to 200 minutes and above 201 minutes. Then, the measures of glycemic variability were compared among the most and least active days and among the groups too. The amount of MVPA was significantly different between the days evaluated (237.49 ± 93.29 vs. 125.21 ± 58.10 minutes), but glycemic variability measures did not present a significant difference. Despite the significant differences in the amount of MVPA between the two days evaluated, the glycemic variability did not change significantly. Arch Endocrinol Metab. 2020;64(3):312-8.
Highlights
The American Diabetes Association (1) recommends strategies to improve the lifestyle of adolescents with type 1 diabetes mellitus (T1DM), such as balanced diet and regular physical activity to optimize glycemic control
Some studies have shown different results when the patients are compared by sex, with worse glycemic and metabolic control among the females, who according to the same studies are more prone to complications in adulthood (22) (23)
Glycemic control was analyzed by glucose variability, using the following measures: standard deviation (SD), low blood glucose index (LBGI), high blood glucose index (HBGI), glycemic risk assessment in diabetes equation (GRADE), mean amplitude of glycemic excursions (MAGE) and coefficient of variation (CV)
Summary
The American Diabetes Association (1) recommends strategies to improve the lifestyle of adolescents with type 1 diabetes mellitus (T1DM), such as balanced diet and regular physical activity to optimize glycemic control. MVPA and glycemic variability in T1DM with T1DM include 60 minutes daily (or more) of aerobic activities of moderate to vigorous intensity (1). It is strongly recommended, physical activity is not always part of the routine of adolescents with T1DM. Some studies suggest that a large proportion of these adolescents do not reach 60 minutes daily of moderate to vigorous physical activity (MVPA) (3) and tend to be less active than their healthy counterparts (4). Glycemic control, analyzed by HbA1c, and its associations with physical activity has been studied and presents contradictory results in the literature, such as: better glycemic control associated with MVPA (7) or non-association between the two variables in a group of patients with T1DM who underwent a 12-weeks training program, where they performed aerobic or resistance exercises (8). In order to explore the associations between physical activity and glycemic control, we aimed to identify the level of physical activity and glycemic variability of adolescents with T1DM, as well as to compare glycemic variability on days with different MVPA amounts
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