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

• Published in: Diabetes care Vol. 38; no. 8; pp. 1536 - 1543
• Main Authors: Bohn, Barbara, Herbst, Antje, Pfeifer, Martin, Krakow, Dietmar, Zimny, Stefan, Kopp, Florian, Melmer, Andreas, Steinacker, Jürgen M., Holl, Reinhard W.
• Format: Journal Article
• Language: English
• Published: United States American Diabetes Association 01.08.2015
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Austria - epidemiology; Blood Glucose - metabolism; Cardiovascular system; Comorbidity; Databases, Factual; Diabetes; 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; Exercise - physiology; Female; Germany - epidemiology; Glycated Hemoglobin A - metabolism; Humans; Hypertension - blood; Hypertension - epidemiology; Hypertension - prevention & control; Hypoglycemia - blood; Hypoglycemia - epidemiology; Hypoglycemia - prevention & control; Impact analysis; Male; Middle Aged; Motor Activity - physiology; Risk factors; Young Adult; Austria; Germany
• ISSN: 0149-5992; 1935-5548; 1935-5548
• DOI: 10.2337/dc15-0030

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. 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. 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). 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.