Impact of Physical Activity on Glycemic Control and Prevalence of Cardiovascular Risk Factors in Adults With Type 1 Diabetes: A Cross-sectional Multicenter Study of 18,028 Patients

Diabetes Care. 2015 Aug;38(8):1536-43. doi: 10.2337/dc15-0030. Epub 2015 May 26.

Abstract

Objective: Physical activity (PA) can improve cardiovascular risk in the general population and in patients with type 2 diabetes. Studies also indicate an HbA(1c)-lowering effect in patients with type 2 diabetes. Since reports in patients with type 1 diabetes are scarce, this analysis aimed to investigate whether there is an association between PA and glycemic control or cardiovascular risk in subjects with type 1 diabetes.

Research design and methods: A total of 18,028 adults (≥18 to <80 years of age) from Germany and Austria with type 1 diabetes from the Diabetes-Patienten-Verlaufsdokumentation (DPV) database were included. Patients were stratified according to their self-reported frequency of PA (PA0, inactive; PA1, one to two times per week; PA2, more than two times per week). Multivariable regression models were applied for glycemic control, diabetes-related comorbidities, and cardiovascular risk factors. Data were adjusted for sex, age, and diabetes duration. P values for trend were given. SAS 9.4 was used for statistical analysis.

Results: An inverse association between PA and HbA(1c), diabetic ketoacidosis, BMI, dyslipidemia (all P < 0.0001), and hypertension (P = 0.0150), as well as between PA and retinopathy or microalbuminuria (both P < 0.0001), was present. Severe hypoglycemia (assistance required) did not differ in PA groups (P = 0.8989), whereas severe hypoglycemia with coma was inversely associated with PA (P < 0.0001).

Conclusions: PA seemed to be beneficial with respect to glycemic control, diabetes-related comorbidities, and cardiovascular risk factors without an increase of adverse events. Hence, our data underscore the recommendation for subjects with type 1 diabetes to perform regular PA.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Austria / epidemiology
  • Blood Glucose / metabolism
  • Databases, Factual
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / prevention & control*
  • Diabetic Angiopathies / blood
  • Diabetic Angiopathies / epidemiology
  • Diabetic Angiopathies / prevention & control*
  • Diabetic Ketoacidosis / blood
  • Diabetic Ketoacidosis / epidemiology
  • Diabetic Ketoacidosis / prevention & control
  • Dyslipidemias / blood
  • Dyslipidemias / complications
  • Dyslipidemias / epidemiology
  • Dyslipidemias / prevention & control
  • Exercise / physiology*
  • Female
  • Germany / epidemiology
  • Glycated Hemoglobin / metabolism
  • Humans
  • Hypertension / blood
  • Hypertension / epidemiology
  • Hypertension / prevention & control
  • Hypoglycemia / blood
  • Hypoglycemia / epidemiology
  • Hypoglycemia / prevention & control
  • Male
  • Middle Aged
  • Motor Activity / physiology
  • Young Adult

Substances

  • Blood Glucose
  • Glycated Hemoglobin A