Trajectories of hemoglobin A1c and body mass index z‐score over four decades among 2 to 18 year olds with type 1 diabetes

The relationship between added sugar and arterial stiffness in youth with type 1 diabetes (T1D) has not been well-described. We used data from the SEARCH for Diabetes in Youth Study (SEARCH), an ongoing observational cohort study, to determine the association between added sugar and arterial stiffness in individuals diagnosed with T1D <20 years of age (n = 1539; mean diabetes duration of 7.9 ± 1.9 years). Added sugar intake was assessed by a food frequency questionnaire, and arterial stiffness measures included pulse wave velocity (PWV) and augmentation index. Separate multivariate linear regression models were used to evaluate the association between added sugar and arterial stiffness. Separate interaction terms were included to test for effect modification by body mass index (BMI) z-score and physical activity (PA). Overall, there was no association between added sugar and arterial stiffness (P > 0.05); however, the association between added sugar and arterial stiffness differed by BMI z-score (P for interaction = 0.003). For participants with lower BMI z-scores, added sugar intake was positively associated with PWV trunk measurements, whereas there was no association for those who had a higher BMI z-score. PA did not significantly modify the association between added sugar and arterial stiffness. Further research is needed to determine the longitudinal relationship and to confirm that obesity differentially affects this association.

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Assessment of Exercise Capacity in Children with Type 1 Diabetes in the Cooper Running Test

International Journal of Sports Medicine ◽

10.1055/a-0805-1326 ◽

2018 ◽

Vol 40 (02) ◽

pp. 110-115 ◽

Cited By ~ 3

Author(s):

Arkadiusz Michalak ◽

Andrzej Gawrecki ◽

Szymon Gałczyński ◽

Jędrzej Nowaczyk ◽

Beata Mianowska ◽

...

Keyword(s):

Body Mass Index ◽

Type 1 Diabetes ◽

Body Mass ◽

Body Fat ◽

Pediatric Population ◽

Body Fat Percentage ◽

Healthy Children ◽

Z Score ◽

Fat Percentage

AbstractRegular physical activity increases lifespan for those with type 1 diabetes. However, disease-related barriers may deter children from exercise and affect their fitness. This study examined the safety of the Cooper test concerning diabetes-related acute complications in children with type 1 diabetes and their fitness. Blood glucose was recorded before and 0, 30, 60 min after the test. The covered distances were transformed to z-scores based on the national charts. Body mass index, body fat percentage and glycated hemoglobin were measured. The run was completed by 80 individuals (45% boys, age 13.6±2.1 years; diabetes duration 6.3±3.5 years). During the follow-up 11 children reached glucose alert values (3–3.9 mmol/L), 3 presented clinically significant hypoglycemia (<3 mmol/L), none experienced severe hypoglycemia. The covered distance was 1914±298 m, not significantly different from the reference population (z-score −0.12±0.71 vs 0, p=0.12). The study participants were more overweight than general pediatric population in terms of body mass index (z-score 0.48±0.94 vs 0, p<0.001) and body fat percentage (z-score: 0.37±0.85 vs 0, p<0.001). In conclusion, the Cooper test can be safely used in children with diabetes to assess their physical capacity. Youth with type 1 diabetes present fitness similar to healthy children but exhibit increased body mass index and adiposity.

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Acute response of intermittent and continuous aerobic exercises on blood glucose of adolescents

Revista Brasileira de Atividade Física & Saúde ◽

10.12820/rbafs.v.22n4p396-403 ◽

2017 ◽

Vol 22 (4) ◽

pp. 396-403

Author(s):

Valderi Lima ◽

Luis Mascarenhas ◽

Juliana Decimo ◽

William Souza ◽

Suzana França ◽

...

Keyword(s):

Body Mass Index ◽

Type 1 Diabetes ◽

Blood Glucose ◽

Body Mass ◽

Intermittent Exercise ◽

Z Score ◽

Exercise Protocol ◽

Continuous Exercise ◽

Significant Difference

The purpose of the study was to investigate the acute effect of continuous and intermittent aerobic exercise on blood glucose of adolescents with type 1 diabetes. A cross-sectional analysis of eight adolescents with type 1 diabetes mellitus (10-15 years) was conducted, and variables such as body mass, height, body mass index z score, glycated hemoglobin and cardiorespiratory fitness were assessed. There were two tests on a cycle ergometer: 30 minutes of continuous exercise and 30 minutes of intermittent exercise. Blood glucose was measured before and after the exercises and lactate concentration was measured at the end of the exercise. Student’s t test and Pearson’s correlation were used, considering p<0.05. In the continuous exercise protocol, there was a significant difference in pre- and post-exercise blood glucose levels (p = 0.048), whereas the intermittent exercise protocol did not show statistically significant differences in blood glucose. Higher concentrations of lactate were found after the intermittent exercises (p = 0.036). There was a strong correlation between glycemic control and body mass index z score (r = 0.893 p = 0.041). Regarding the other variables, there were no significant correlations. The reduction in blood glucose was lower after intermittent aerobic exercises, compared with continuous exercises, which could be an interesting strategy to prevent acute exercise-induced hypoglycemia.

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Relationship between hypoglycaemia, body mass index and quality of life among patients with type 1 diabetes: Observations from the DEPICT clinical trial programme

Diabetes Obesity and Metabolism ◽

10.1111/dom.13972 ◽

2020 ◽

Vol 22 (5) ◽

pp. 857-865

Author(s):

Jason Gordon ◽

Lee Beresford‐Hulme ◽

Hayley Bennett ◽

Amarjeet Tank ◽

Christopher Edmonds ◽

...

Keyword(s):

Quality Of Life ◽

Clinical Trial ◽

Body Mass Index ◽

Type 1 Diabetes ◽

Body Mass ◽

Clinical Trial Programme

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Effects of Metformin Added to Insulin in Adolescents with Type 1 Diabetes: An Exploratory Crossover Randomized Trial

Journal of Diabetes Research ◽

10.1155/2020/7419345 ◽

2020 ◽

Vol 2020 ◽

pp. 1-10

Author(s):

Daizhi Yang ◽

Jinhua Yan ◽

Hongrong Deng ◽

Xubin Yang ◽

Sihui Luo ◽

...

Keyword(s):

Body Mass Index ◽

Heart Rate ◽

Heart Rate Variability ◽

Type 1 Diabetes ◽

Insulin Sensitivity ◽

Body Mass ◽

Autonomic Function ◽

Insulin Dose ◽

Glucose Variability

Background. To comprehensively assess the effects of metformin added to insulin on metabolic control, insulin sensitivity, and cardiovascular autonomic function in adolescents with type 1 diabetes. Materials and Methods. This was an exploratory, crossover, randomized trial conducted in adolescents with type 1 diabetes aged 12-18 years old. Participants were randomly received metformin (≤1000 mg/d) added to insulin for 24 weeks followed by insulin monotherapy for a subsequent 24 weeks or vice versa. Blood pressure, body mass index, insulin dose, estimated insulin sensitivity, glycated hemoglobin A1c (HbA1c), and lipid profiles were measured, with a 72-hour continuous glucose monitoring and 24-hour Holter monitoring performed at baseline, 24, and 50 weeks for the assessments of glucose variability and heart rate variability. Results. Seventeen patients with mean ± SD age 14.4 ± 2.3 years , body mass index 18.17 ± 1.81 kg / m 2 , median (IQR) diabetes duration 4.50 (3.58, 6.92) years, and HbA1c 9.0% (8.5%, 9.4%) were enrolled. The between-group difference in HbA1c of 0.28% (95% CI -0.39 to 0.95%) was not significant ( P = 0.40 ). Changes in body mass index, insulin dose, blood pressure, lipid profiles, and estimated insulin sensitivity were similar for metformin add-on vs. insulin monotherapy. Glucose variability also did not differ. Compared with insulin monotherapy, metformin add-on significantly increased multiple heart rate variability parameters. Conclusions. Metformin added to insulin did not improve metabolic control or glucose variability in lean/normal-weight adolescents with type 1 diabetes. However, metformin added to insulin significantly increased heart rate variability, suggesting that metformin might improve cardiovascular autonomic function in this population.

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