Share This Article:

Effects of Exercise in Children and Adolescent with Type 1 Diabetes Mellitus

Abstract Full-Text HTML XML Download Download as PDF (Size:625KB) PP. 1357-1365
DOI: 10.4236/health.2015.710150    2,619 Downloads   3,290 Views   Citations


Exercise is one of the most important components, together with insulin therapy and diet, in the clinical management of type 1 diabetes mellitus (T1DM). Physical activity has multiple health benefits, like blood pressure reduction, improvement of cardiovascular fitness and lipoprotein profile. The benefits for children with diabetes may also include positive effects on glycemic metabolism. The following review examines the main studies about the effects of exercise on diabetes. Additional longitudinal studies are needed to verify the hypothetical positive relationship between sport and T1DM and between sport and diabetic complications. However, aerobic and moderate intensity physical activity in children and adolescents with T1DM should be encouraged also for its beneficial psychological effects.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Iughetti, L. , Gavioli, S. , Bonetti, A. and Predieri, B. (2015) Effects of Exercise in Children and Adolescent with Type 1 Diabetes Mellitus. Health, 7, 1357-1365. doi: 10.4236/health.2015.710150.


[1] Marliss, E.B. and Vranic, M. (2002) Intense Exercise Has Unique Effects on Both Insulin Release and Its Roles in Glucoregulation. Diabetes, 51, S271-S283.
[2] Kreisman, S., Mew, N., Arsenault, M., et al. (2000) Epinephrine Infusion during Moderate Intensity Exercise Increases Glucose Production and Uptake. American Journal of Physiology, 278, E949-E957.
[3] Bradley, Z., Allison, R., Lacy, B. and Wasserman, D. (1997) Interaction of Exercise, Insulin, and Hypoglycemia Studied Using Euglycemic and Hypoglycemic Insulin Clamps. American Journal of Physiology, 272, E530-E542.
[4] Thorell, A., Hirshman, M.F., Nygren, J., et al. (1999) Exercise and Insulin Cause GLUT-4 Translocation in Human Skeletal Muscle. American Journal of Physiology, 277, E733-E741.
[5] Marliss, E., Simantirakis, E., Gougeon, P., Halter, C. and Vranic, M. (1991) Glucoregulatory and Hormonal Responses to Repeated Bouts of Intense Exercise in Normal Male Subjects. Journal of Applied Physiology, 71, 924-933.
[6] Romijn, J.A., Coyle, E.F., Sidossis, L.S., et al. (1993) Regulation of Endogenous Fat and Carbohydrate Metabolism in Relation to Exercise Intensity and Duration. American Journal of Physiology, 265, E380-E391.
[7] Romijn, J.A., Coyle, E.F., Sidossis, L.S., Rosenblatt, J. and Wolfe, R.R. (2000) Substrate Metabolism during Different exercise Intensities in Endurance-Trained Women. Journal of Applied Physiology, 88, 1707-1714.
[8] De Feo, P., Di Loreto, C., Lucidi, P., et al. (2003) Metabolic Response to Exercise. Journal of Endocrinological Investigation, 26, 851-854.
[9] Jeukendrup, A., Wagenmakers, A., Stegen, J., Gijsen, A., Brouns, F. and Saris, W. (1999) Carbohydrate Ingestion Can Completely Suppress Endogenous Glucose Production during Exercise. American Journal of Physiology, 276, E672- E683.
[10] Wasserman, D.H. and Zinman, B. (1995) Fuel Homeostasis in “The Health Professional’s Guide to Diabetes and Exercise”. ADA Clinical Education Series, 29-47.
[11] Frid, A., Ostman, J. and Linde, B. (1990) Hypoglycaemia Risk during Exercise after Intramuscular Injection of Insulin in the Thigh of IDDM. Diabetes Care, 8, 337-343.
[12] Robertson, R.P., Halter, J.B. and Porte Jr., D. (1976) A Role for Alpha-Adrenergic Receptors in Abnormal Insulin Secretion in Diabetes Mellitus. Journal of Clinical Investigation, 57, 791-795.
[13] MacDonald, M.J. (1987) Postexercise Late-Onset Hypoglycemia in Insulin-Dependent Diabetic Patients. Diabetes Care, 10, 584-588.
[14] Zinman, B., Murray, F.T., Vranic, M., Albisser, A.M., Leibel, B.S., Mcclean, P.A. and Marliss, E.B. (1977) Glucoregulation during Moderate Exercise in Insulin Treated Diabetics. The Journal of Clinical Endocrinology & Metabolism, 45, 641-652.
[15] Schneider, S.H., Vitug, A., Ananthakrishnan, R. and Khachadurian, A.K. (1991) Impaired Adrenergic Response to Prolonged Exercise in Type I Diabetes. Metabolism, 40, 1219-1225.
[16] Galassetti, P., Tate, D., Neill, R., Morrey, S., Wasserman, D. and Davis, S. (2003) Effect of Antecedent Hypoglycemia on Counterregulatory Responses to Subsequent Euglycemic Exercise in Type 1 Diabetes. Diabetes, 52, 1761-1769.
[17] Sandoval, D., Aftab Guy, D., Richardson, A., Ertl, A. and Davis, S. (2004) Effects of Low and Moderate Antecedent Exercise on Counterregulatory Responses to Subsequent Hypoglycemia in Type 1 Diabetes. Diabetes, 53, 1798-1806.
[18] Koivisto, V. and Felig, P. (1978) Effects of Leg Exercise on Insulin Absorption in Diabetic Patients. New England Journal of Medicine, 298, 79-83.
[19] Berger, M., Berchtold, P., Cuppers, H.J., Drost, H., Kley, H.K., Müller, W.A., et al. (1977) Metabolic and Hormonal Effects of Muscular Exercise in Juvenile Type Diabetics. Diabetologia, 13, 355-365.
[20] Berger, M., Assal, J.P. and Jorgens, V. (1980) Physical Exercise in the Diabetic. The Importance of Understanding Endocrine and Metabolic Responses. Diabetes & Metabolism, 6, 59-69.
[21] Purdon, C., Brousson, M., Nyveen, S.L., Miles, P.D., Halter, J.B., Vranic, M. and Marliss, E.B. (1993) The Role of Insulin and Catecholamines in the Glucoregolatory Response during Intense Exercise and Early Recovery in Insulin-Dependent Diabetic and Control Subjects. The Journal of Clinical Endocrinology & Metabolism, 76, 566-573.
[22] Mitchell, T.H., Abraham, G., Shiffrin, A., Leiter, L.A. and Marliss, E.B. (1988) Hyperglycemia after Intense Exercise in IDDM Subjects during Continuous Subcutaneous Insulin Infusion. Diabetes Care, 11, 311-317.
[23] American Diabetes Association (2004) Physical Activity/Exercise and Diabetes. Diabetes Care, 27, S58-S62.
[24] Rasmussen, O.W., Lauszus, F.F. and Hermansen, K. (1994) Effects of Postprandial Exercise on Glycemic Response in IDDM Subjects: Studies at Constant Insulinemia. Diabetes Care, 17, 1203-1205.
[25] Huttunen, N.P., Kaar, M.L., Knip, M., Mustonen, A., Puukka, R. and Akerblom, H.K. (1984) Physical Fitness of Children and Adolescents with Insulin-Dependent Diabetes Mellitus. Annals of Clinical Research, 16, 1-5.
[26] Ludvigsson, J. (1980) Physical Exercise in Relation to Degree of Metabolic Control in Juvenile Diabetics. Acta Paediatrica, 69, 45-48.
[27] Huttunen, N.P., Lankela, S.L., Knip, M., Lautala, P., Kaar, M.-L., Laasonen, K. and Puukka, R. (1989) Effect of Once-a-Week Training Program on Physical Fitness and Metabolic Control in Children with IDDM. Diabetes Care, 12, 737-740.
[28] Sackey, A.H. and Jefferson, I.G. (1996) Physical Activity and Glycemic Control in Children with Diabetes Mellitus. Diabetic Medicine, 13, 789-793.<789::AID-DIA184>3.0.CO;2-5
[29] Herbst, A., Bachran, R., Kapellen, T. and Holl, R.W. (2006) Effects of Regular Physical Activity on Glycemic Control in Children with Diabetes Mellitus Type 1. Archives of Pediatrics and Adolescent Medicine, 160, 573-577.
[30] Dahl-Jorgensen, K., Meen, H.D., Hanssen, K.F. and Aagenaes, O. (1980) The Effect of Exercise on Diabetic Control and Hemoglobin A1 (HbA1) in Children. Acta Paediatrica, 69, 53-56.
[31] Stratton, R., Wilson, D.P., Endres, R.K. and Goldstein, D.E. (1987) Improved Glycemic Control after Supervised 8-wk Exercise Program in Insulin-Dependent Diabetic Adolescents. Diabetes Care, 10, 589-593.
[32] Campaigne, B.N., Gilliam, T.B., Spencer, M.L., Lampman, R.M. and Schork, M.A. (1984) Effects of a Physical Activity Program on Metabolic Control and Cardiovascular Fitness in Children with Insulin Dependent Diabetes Mellitus. Diabetes Care, 7, 57-62.
[33] Mauvais-Jarvis, F., Sobngwi, E., Porcher, R., Garnier, J.P., Vexiau, P., Duvallet, A. and Gautier, J.-F. (2003) Glucose Response to Intense Aerobic Exercise in Type 1 Diabetes: Maintenance of Near Euglycemia Despite a Drastic Decrease in Insulin Dose. Diabetes Care, 26, 1316-1317.
[34] Mosher, P.E., Nash, M.S., Perry, A.C., LaPerriere, A.R. and Goldberg, R.B. (1998) Aerobic Circuit Exercise Training: Effect on Adolescents with Well-Controlled Insulin-Dependent Diabetes Mellitus. Archives of Physical Medicine and Rehabilitation, 79, 652-657.
[35] Larsson, Y., Persson, B., Sterky, G. and Thoren, C. (1964) Functional Adaptation to Vigorous Training and Exercise in Diabetic and Nondiabetic Adolescents. Journal of Applied Physiology, 19, 629-635.
[36] Landt, K.W., Campaigne, B.N., James, F.W. and Sperling, M.A. (1985) Effects of Exercise Training on Insulin Sensitivity in Adolescents with Type I Diabetes. Diabetes Care, 8, 461-465.
[37] Roberts, L., Jones, T.W. and Fournier, P.A. (2002) Exercise Training and Glycemic Control in Adolescents with Poorly Controlled Type 1 Diabetes Mellitus. Journal of Pediatric Endocrinology and Metabolism, 15, 621-627.
[38] Zinman, B., Zuniga, S. and Kelley, D. (1984) Comparison of the Acute and Long Term Effects of Exercise on Glucose Control in Type 1 Diabetes. Diabetes Care, 7, 515-519.
[39] Huttunen, J.K., Lanisimies, E., Voutilainen, E., Ehnholm, C., Hietanen, E., Penttila, I., et al. (1979) Effect of Moderate Physical Exercise on Serum Lipoprotein. Circulation, 60, 1220-1229.
[40] Idzior-Walus, B., Mattock, M.B., Solnica, B., Stevens, L., Fuller, J.H. and the EURODIAB IDDM Complications Study Group (2001) Factors Associated with Plasma Lipids and Lipoproteins in Type 1 Diabetes Mellitus: The EURODIAB IDDM Complications Study. Diabetic Medicine, 18, 786-796.
[41] Herbst, A., Kordonouri, O., Schwab, K.O., Schmidt, F., Holl, R.W., et al. (2007) Impact of Physical Activity on Cardiovascular Risk Factors in Children with Type 1 Diabetes. Diabetes Care, 30, 2098-2100.
[42] Swerdlow, A.J. and Jones, M.E. (1996) Mortality during 25 Years of Follow of a Cohort with Diabetes. International Journal of Epidemiology, 25, 1250-1261.
[43] Wasserman, D.H. and Zinman, B. (1994) Exercise in Individuals with IDDM. Diabetes Care, 17, 924-937.
[44] Mogensen, C.E. and Vittinghus, E. (1975) Urinary Albumin Excretion during Exercise in Juvenile Diabetes. Scandinavian Journal of Clinical and Laboratory Investigation, 35, 295-300.
[45] Viberti, G.C., Jarrett, R.J. and McCartney, K.H. (1978) Increased Glomerular Permeability to Albumin Induced by Exercise in Diabetic Subjects. Diabeto-logia, 14, 293-300.
[46] Hilsted, J., Galbo, H. and Christensen, N.J. (1979) Impaired Cardiovascular Responses to Graded Exercise in Diabetic Autonomic Neuropathy. Diabetes, 28, 313-319.
[47] Kahn, J.K., Zola, B., Juni, J.E. and Vinik, A.I. (1986) Decreased Exercise Heart Rate and Blood Pressure Response in Diabetic Subjects with Cardiac Autonomic Neuropathy. Diabetes Care, 9, 389-394.
[48] Margonato, A.P., Gerundini, P., Vicedomini, G., Gilardi, M.C., Pozza, G. and Fazio, F. (1986) Abnormal Cardiovascular Response to Exercise in Young Asymptomatic Diabetic Patients with Retinopathy. American Heart Journal, 112, 554-560.
[49] Colhoun, H.M., Francis, D.P., Rubens, M.B., Underwood, S.R. and Fuller, J.H. (2001) The Association of Heart-Rate Variability with Cardiovascular Risk Factors and Coronary Artery Calcification: A Study in Type 1 Diabetic Patients and the General Population. Diabetes Care, 24, 1108-1114.
[50] Kriska, A.M., LaPorte, R.E., Patrick, S.L., Kuller, L.H. and Orchard, T.J. (1991) The Association of Physical Activity and Diabetic Complications in Individuals with Insulin-Dependent Diabetes Mellitus: The Epidemiology of Diabetes Complications Study—VII. Journal of Clinical Epidemiology, 44, 1207-1214.
[51] Waden, J., Forsblom, C., Thorn, L.M., Sraheimo, M., Rosengard-Barlund, M., Heikkila, O., et al. (2008) Physical Activity and Diabetes Complications in Patients with Type 1 Diabetes. Diabetes Care, 31, 230-232.

comments powered by Disqus

Copyright © 2018 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.