Influence of combined aerobic and resistance training on metabolic control,cardiovascular fitness and quality of life in adolescents with type 1 diabetes: a randomized controlled trial
Restricted accessResearch articleFirst published online April, 2011
Influence of combined aerobic and resistance training on metabolic control,cardiovascular fitness and quality of life in adolescents with type 1 diabetes: a randomized controlled trial
Objective: To evaluate the effect of combined exercise training on metabolic control, physical fitness and quality of life in adolescents with type 1 diabetes.
Design: A double-blind randomized controlled trial with patients receiving combined aerobic and strength or no training.
Setting: University Hospital Ghent (Belgium).
Subjects: Sixteen children with type 1 diabetes were randomized into a control group (n = 8) and an intervention group (n = 8).
Interventions: Patients participated twice a week for 20 weeks in the combined aerobic and strength group. The control group continued their normal daily activities.
Main measures: Before and after the intervention anthropometric variables (weight, length, BMI, body composition), metabolic control (glycaemia, HbA1c, daily insulin injected), aerobic capacity (peak Vo2, peak power, peak heart rate, 6-minute walk distance), strength (1 repetition maximum of upper and lower limb, hand grip strength, muscle fatigue resistance, sit-to-stand) and quality of life (SF-36) were assessed.
Results: At baseline, none of the measured parameters differed significantly between the two groups. There was no significant evolution in the groups concerning anthropometric indices, glycaemia and HbA1c. However, the daily doses of insulin injected were significantly lowered in the training group (0.96IU/kg.day pre versus 0.90IU/kg.day post; P <0,05), while it was increased in the control group. Physical fitness increased significantly in the training group. General health, vitality and role emotional had a tendency to improve.
Conclusion: Combined exercise training seemed to lower daily insulin requirement and improve physical fitness, together with better well-being.
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References
1.
BunnJGabbayKGallopP. The glycosylation of hemoglobin: relevance to diabetes mellitus. Science 1981; 200: 21–4.
2.
PirartJ. Diabetes mellitus and its degenerative complications: a prospective study of 4,400 patients observed between 1947 and 1973. Diabetes Care 1978; 1: 168–88.
3.
RenoldAEStauffacherWCahill JrGF. Diabetes mellitus. In: StanbaryJBWyngaardenJBFredricksonDS (eds) The metabolic basis of inherited disease . New York: McGraw-Hill, 2000, 234–46.
4.
ZinmanBZuniga-GuajardoSKellyD. Comparison of the acute and long-term effects of exercise on glucose control in type 1 diabetes. Diabetes Care 1984; 7: 515–19.
5.
American College of Sports Medicine. American College of Sports Medicine position stand. Progression models in resistance training for healthy adults. Med Sci Sports Exer 2009; 41: 687–708.
6.
PollockMLGaesserGAButcherJD. ACSM Position Stand: The recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in healthy adults. Med Sci Sports Exerc 1998; 30: 975–91.
7.
US Department of Health and Human Services. The Surgeon General’s call to action to prevent and decrease overweight and obesity. Rockville, MD: US Department of Health and Human Services, Public Health Service, Office of the Surgeon General, 2001.
8.
CampaigneBNGilliamTBSpencerMLLampmanRMSchorkMA. Effects of a physical activity program on metabolic control and cardiovascular fitness in children with insulin-dependent diabetes mellitus. Diabetes Care 1984; 7: 57–62.
9.
Dahl-JørgensenKMeenHDHanssenKFAagenaesO. The effect of exercise on diabetic control and hemoglobin A1 (HbA1) in children. Acta Paediatr Scand Suppl 1980; 283: 53–6.
10.
LaaksonenDEAtalayMNiskanenLK. Aerobic exercise and the lipid profile in type-1 diabetic men: a randomized controlled trial. Med Sci Sports Exerc 2000; 32: 1541–48.
11.
LandtKWCampaigneBNJamesFWSperlingMA. Effects of exercise training on insulin sensitivity in adolescents with type I diabetes. Diabetes Care 1985; 8: 461–65.
12.
RowlandR. Physical fitness in children: implications for the prevention of coronary artery disease. Curr Prob Pediatr 1981; 11: 1–5.
13.
Wallberg-HenrikssonH. Exercise and diabetes mellitus. Exerc Sport Sci Rev 1992; 20: 339–68.
14.
PeirceNS. Diabetes and exercise. Br J Sports Med 1999; 33: 161–72.
15.
RamalhoACde Lourdes LimaMNunesF. The effect of resistance versus aerobic training on metabolic control in patients with type 1 diabetes mellitus. Diabetes Res Clin Pract 2006; 72: 271–76.
16.
MosherPENashMSPerryACLaPerriereARGoldbergRB. Aerobic circuit training: effect on adolescents with well-controlled insulin-dependent diabetes mellitus. Arch Phys Med Rehabil 1998; 79: 652–57.
17.
HeymanEToutainCDelamarcheP. Exercise training and cardiovascular risk factors in type 1 diabetic adolescent girls. Pediatr Exerc Sci 2007; 19: 408–19.
18.
WagnerVMMüller-GodeffroyEvon SengbuschSHägerSThyenU. Age, metabolic control and type of insulin regime influences health-related quality of life in children and adolescents with type 1 diabetes mellitus. Eur J Pediatr 2005; 164: 491–96.
19.
WiesingerGFPleinerJQuittanM. Health related quality of life in patients with long-standing insulin dependent (type 1) diabetes mellitus: benefits of regular physical training. Wien Klin Wochenschr 2001; 113: 670–75.
20.
SchaeferFGeorgiMZiegerASchärerK. Usefulness of bioelectric impedance and skinfold measurements in predicting fat-free mass derived from total body potassium in children. Pediatr Res 1994; 35: 617–24.
21.
American Thoracic Society and American College of Chest Physicians. ATS/ACCP Statement on cardiopulmonary exercise testing. Am J Respir Crit Care 2003; 167: 211–77.
22.
EnrightPL. The six-minute walk test. Respir Care 2003; 48: 783–85.
23.
WathenD. Load assignment. In: BaechleTR (ed.) Essentials of strength training and conditioning . Champaign, IL: Human Kinetics, 1994, 435–46.
24.
JonesCJRikliREBeamWC. A 30-s chair-stand test as a measure of lower body strength in community-residing older adults. Res Q Exerc Sports 1999; 332: 113–19.
25.
BautmansIMetsT. A fatigue resistance test for elderly persons based on grip strength: reliability and comparison with healthy young subjects. Aging Clin Exp Res 2005; 17: 217–22.
26.
Van der Zee KI, Sanderman R. Het meten van de gezondheidstoestand met de RAND-36: een handleiding. Noordelijk Centrum voor Gezondheidsvraagstukken, 1993.
27.
TonellaPFlückCEMullisPE. Metabolic control of type 1 diabetic patients followed at the University Children’s Hospital in Berne: have we reached the goal?Swiss Med Wkly 2010; 24: 140–140.
28.
RöcklKSWitczakCAGoodyearLJ. Signaling mechanisms in skeletal muscle: acute responses and chronic adaptations to exercise. IUBMB Life 2008; 60: 145–53.
29.
SegerströmABGlansFErikssonKFGroopLThorssonOWollmerP. Assessment of exercise capacity in women with type 2 diabetes. Clin Physiol Funct Imaging 2008; 28: 294–98.
30.
CaldersPDeforcheBVerscheldeS. Predictors of 6-minute walk test and 12-minute walk/run test in obese children and adolescents. Eur J Pediatr 2008; 167: 563–68.
31.
BernardiMRosponiACastellanoV. Determinants of sit-to-stand capability in the motor impaired elderly. J Electromyogr Kinesiol 2004; 14: 401–10.
32.
SartorioALafortunaCLPogliaghiSTrecateL. The impact of gender, body dimension and body composition on hand-grip strength in healthy children. J Endocrinol Invest 2002; 25: 431–35.
33.
BernardiniALVanelliMChiariG. Adherence to physical activity in young people with type 1 diabetes. Acta Biomed 2004; 75: 153–57.
34.
Olbrecht J. Definitions and principles of training. In The science of winning, second edition. Luton, Beds: F & G Partners; Partners in Sports, 2007: 1–14.
