Diabetes Care, Vol 20, Issue 10 1603-1611, Copyright © 1997 by American Diabetes Association

ARTICLES

Impact of physical activity on cardiovascular risk factors in IDDM

R Lehmann, V Kaplan, R Bingisser, KE Bloch and GA Spinas
Division of Endocrinology and Diabetes, University Hospital Zurich, Switzerland.

OBJECTIVE: To study the impact of physical activity on glycemic control and plasma lipids [HDL cholesterol (HDL-C), HDL-C subfractions, triglycerides, lipoprotein(a)], blood pressure, weight, and abdominal fat and to determine the necessary short-term adaptations in diabetes management during intensive endurance training in patients with IDDM. RESEARCH DESIGN AND METHODS: Well-controlled subjects with IDDM (n = 20; HbA1c = 7.6%) engaged in a regular exercise program over a period of 3 months involving endurance sports such as biking, long-distance running, or hiking. Subjects were instructed to exercise at least 135 min per week. If baseline activity exceeded this level, subjects were to increase further their physical activity as much as possible and record the type and time of such activity. RESULTS: During the 3-month intervention, physical activity increased from 195 +/- 176 to 356 +/- 164 min (mean +/- SD) per week (P < 0.001). Physical fitness as assessed by VO2max increased from 2,914 +/- 924 to 3,092 +/- 905 ml/min (P < 0.001), and insulin sensitivity increased significantly (steady-state plasma glucose [SSPG] decreased from 10.5 +/- 4.8 to 7.0 +/- 3.3 mmol/l; P < 0.01). Subsequently, LDL cholesterol decreased by 14% (P < 0.05), and HDL and HDL3-C subfraction increased by 10 (P < 0.05) and 16% (P < 0.05), respectively. Systolic and diastolic blood pressure decreased significantly from 127 +/- 9 to 124 +/- 8 (P < 0.05) and from 80 +/- 5 to 77 +/- 5 mmHg (P < 0.01), respectively. Resting heart rate decreased from 63 +/- 6 to 59 +/- 7 bpm (P < 0.01). Waist-to-hip circumference ratio decreased from 0.882 +/- 0.055 to 0.858 +/- 0.053 (P < 0.001), body weight decreased from 70.7 +/- 10.4 to 68.7 +/- 10.2 kg (P = 0.003), with a consequent decrease in body fat from 21.9 +/- 8.2 to 18.0 +/- 6.3% (P < 0.001) and an increase in lean body mass from 54.9 +/- 12.2 to 56.8 +/- 11.0 kg. These effects occurred independently of glycemic control. The overall frequency of severe hypoglycemic episodes was reduced from 0.14 to 0.10 per patient-year during the study period. CONCLUSIONS: This study shows that increasing physical activity is safe and does not result in more hypoglycemic episodes and that there is a linear dose-response between increased physical activity and loss of abdominal fat and a decrease in blood pressure and lipid-related cardiovascular risk factors, with a preferential increase in the HDL3-C subfraction.
CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				J. Kavookjian, B. M. Elswick, and T. Whetsel Interventions for Being Active Among Individuals With Diabetes: A Systematic Review of the Literature The Diabetes Educator, November 1, 2007; 33(6): 962 - 988. [Abstract] [Full Text] [PDF]

				R. Loganathan, M. Bilgen, B. Al-Hafez, S. V. Zhero, M. D. Alenezy, and I. V. Smirnova Exercise training improves cardiac performance in diabetes: in vivo demonstration with quantitative cine-MRI analyses J Appl Physiol, February 1, 2007; 102(2): 665 - 672. [Abstract] [Full Text] [PDF]

				D. G. Haider, J. Pleiner, M. Francesconi, G. F. Wiesinger, M. Muller, and M. Wolzt Exercise Training Lowers Plasma Visfatin Concentrations in Patients with Type 1 Diabetes J. Clin. Endocrinol. Metab., November 1, 2006; 91(11): 4702 - 4704. [Abstract] [Full Text] [PDF]

				A. Herbst, R. Bachran, T. Kapellen, R. W. Holl, and for the DPV Science Initiative Effects of Regular Physical Activity on Control of Glycemia in Pediatric Patients With Type 1 Diabetes Mellitus Arch Pediatr Adolesc Med, June 1, 2006; 160(6): 573 - 577. [Abstract] [Full Text] [PDF]

				I. W Gallen Review: Helping the athlete with type 1 diabetes The British Journal of Diabetes & Vascular Disease, March 1, 2004; 4(2): 87 - 92. [Abstract] [PDF]

				A. Trichopoulou, C. Gnardellis, A. Lagiou, V. Benetou, A. Naska, and D. Trichopoulos Physical activity and energy intake selectively predict the waist-to-hip ratio in men but not in women Am. J. Clinical Nutrition, November 1, 2001; 74(5): 574 - 578. [Abstract] [Full Text] [PDF]

				R. Rabasa-Lhoret, J. Bourque, F. Ducros, and J.-L. Chiasson Guidelines for Premeal Insulin Dose Reduction for Postprandial Exercise of Different Intensities and Durations in Type 1 Diabetic Subjects Treated Intensively With a Basal-Bolus Insulin Regimen (Ultralente-Lispro) Diabetes Care, April 1, 2001; 24(4): 625 - 630. [Abstract] [Full Text]

				R. C. Plotnikoff, S. Brez, and S. B. Hotz Exercise Behavior in a Community Sample With Diabetes: Understanding the Determinants of Exercise Behavioral Change The Diabetes Educator, May 1, 2000; 26(3): 450 - 459. [PDF]