Physical activity in type 1 diabetic young and early adults treated with insulin pump therapy. A preliminary report.

Purpose: To determine the level of physical activity in young and early adults with type 1 diabetes in comparison with their healthy counterparts and to determine whether the use of insulin pump facilitates physical activity. Materials and methods: This study included 40 type 1 diabetes (T1D) subjects of both sexes treated with a personal insulin pump therapy, and 30 healthy controls. The diagnostic survey included questions about nutrition, knowledge about the disease and whether the patient can control diabetes through physical activity, diet and self-monitoring. The International Physical Activity Questionnaire – long form (IPAQ-L), was used to assess the level of physical activity of both diabetic and control individuals. Results: 87.5% T1D subjects believe that using an insulin pump facilitates their physical activity. The level of physical activity associated with cycling (p=0.038) and vigorous physical activity (p=0.008) was higher in T1D than in the control group. Statistically significant differences (p=0.043) were found for total physical activity. The total mean activity was higher in participants with T1D (8147.70 MET-min/week) compared to the control group (5857.55 MET-min/week). Conclusions: Young and early adults with type 1 diabetes may be more physically active than their healthy counterparts, mainly in their leisure time. The use of a personal insulin pump facilitates physical activity, but most diabetics experience episodes of hypoglycemia after physical activity.

Download Full-text

Active Subjects with Autoimmune Type 1 Diabetes have Better Metabolic Profiles than Sedentary Controls

Cell Transplantation ◽

10.3727/096368916x693022 ◽

2017 ◽

Vol 26 (1) ◽

pp. 23-32 ◽

Cited By ~ 10

Author(s):

M. Adamo ◽

R. Codella ◽

F. Casiraghi ◽

A. Ferrulli ◽

C. Macrì ◽

...

Keyword(s):

Physical Activity ◽

Type 1 Diabetes ◽

Insulin Pump ◽

Glycosylated Hemoglobin ◽

High Volume ◽

Insulin Pump Therapy ◽

Pump Therapy ◽

Glucose Levels ◽

Nonobese Diabetic Mice

Previous studies in humans with type 1 diabetes mellitus (T1D) and in nonobese diabetic mice have investigated the beneficial immunomodulatory potential of aerobic physical activity. Performing high volume of aerobic exercise may favorably regulate autoimmunity in diabetes. We tested whether increased physical activity is a self-sufficient positive factor in T1D subjects. During a 3-month observational period, active (six males; 40.5 ± 6.1 years; BMI: 24.5 ± 2.1) and sedentary (four males, three females; 35.9 ± 8.9 years; BMI: 25.7 ± 3.8) T1D individuals on insulin pump therapy were studied for metabolic, inflammatory, and autoimmune parameters. At baseline and at the end of a 3-month period, glycosylated hemoglobin (HbA1c), autoantibodies (anti-GAD, anti-ZnT8, anti-IA2, and ICA) and proinflammatory cytokines (IL-6 and TNF-α) were evaluated. During the third month of the period, physically active T1D patients showed a significant reduction in the average glucose levels (-9%, p = 0.025, by CGM) compared to the first month values, and even their hyperglycemic episodes (>180 mg/dl) diminished significantly (-24.2%, p = 0.032 vs. first month). Moreover, active T1D subjects exhibited an improved body composition with respect to sedentary controls. No significant changes were detected as to the autoimmune and inflammatory profiles. This study confirms the beneficial role of physical exercise associated with insulin pump therapy in order to improve metabolic control in individuals with T1D. These preliminary positive observations need to be challenged in a prolonged interventional follow-up.

Download Full-text

Contrasting Challenges of Insulin Pump Therapy in a Toddler and Adolescent With Type 1 Diabetes

The Diabetes Educator ◽

10.1177/0145721705278888 ◽

2005 ◽

Vol 31 (4) ◽

pp. 584-590 ◽

Cited By ~ 1

Author(s):

Elizabeth A. Doyle ◽

Amy T. Steffen ◽

William V. Tamborlane

Keyword(s):

Type 1 Diabetes ◽

Glycemic Control ◽

Insulin Pump ◽

Insulin Pump Therapy ◽

Pump Therapy ◽

Diabetes Clinic ◽

Physically Active ◽

Parental Assistance ◽

Life Improvement

Purpose To describe the challenges and outcomes of continuous subcutaneous insulin infusion (CSII) pump therapy in a toddler and adolescent with type 1 diabetes. Insight into patient-family aspects motivating pump use is provided. Methods Two cases treated at the Pediatric Diabetes Clinic at Yale University. Results Upon parental request, CSII was initiated to improve glycemic control in a 4-year-old boy (case 1) with unpredictable food intake. During 68 months of CSII therapy, hemoglobin A1C levels averaged 6.3% ± 0.6%. Severe hypoglycemic episodes ceased 36 months ago, and occasional postprandial hyperglycemia during early school years was corrected with school nurses’ reminders about premeal insulin bolus doses. Currently 9.5 years old, he independently manages all his insulin injections with parental assistance only to change the catheter site. Case 2 is a girl who was nearly 12 years of age when diagnosed with type 1 diabetes. Initially managed with daily injections, hypoglycemic episodes were interfering with her physically active lifestyle. At age 13 years, she elected CSII therapy, and glycemic control improved. Temporarily erratic in the immediate period pre- and postmenarche, metabolic control has since stabilized. At 15 years old, she successfully manages her diabetes independently. Conclusions To optimize glycemic control, CSII can be initiated and used effectively, both in children of all ages and in adolescents with type 1 diabetes. CSII may be ideal therapy for toddlers, with no apparent lower age boundary for initiating CSII; however, the parenting challenges and requirements for supportive education differ between toddlers and adolescents. When disease and pump management are appropriately individualized, CSII therapy can help children with diabetes achieve and sustain glycemic control. Lifestyle flexibility, quality-of-life improvement, and independence can thus begin early in childhood and be maintained throughout young adulthood.

Download Full-text