ABSTRACT
In brief: The acute effect of exercise on blood glucose was observed on 130 occasions in eight adolescents with insulin-dependent diabetes mellitus. All subjects engaged in 30 minutes of either structured aerobic exercise or unstructured recreational activity. The magnitude of decline in the blood glucose level with exercise corresponded to the preexercise blood glucose value: Higher preexercise values were associated with larger declines, while nonelevated preexercise values were associated with smaller declines. No significant differences in glycemic effect were observed between the two categories of exercise. The authors conclude that in adolescents with moderately well-controlled diabetes, recreational activities can be as effective in lowering elevated blood glucose levels as structured exercise.
ABSTRACT
Eight insulin-dependent adolescents (4 boys, 4 girls) participated in an 8-wk program of supervised exercise, and 8 matched controls were encouraged to exercise on their own without supervision. All 16 subjects were asked to follow a standard ADA diet plan, kept a self-reported log of caloric intake, and met with a dietitian weekly to review their diets. Exercise for the supervised subjects was scheduled between the routine afternoon snack and the evening meal, and subjects were asked not to consume additional food on exercise days. After the 8-wk program, glycemic control, as measured by glycosylated serum albumin and blood glucose values (but not by glycosylated hemoglobin), improved in the supervised-exercise group despite reduced daily insulin dosage. Cardiorespiratory fitness, as measured by voluntary maximum treadmill time (Bruce protocol) and submaximal exercise heart rates, also improved. No changes were observed in the unsupervised control group.
Subject(s)
Blood Glucose/metabolism , Diabetes Mellitus, Type 1/therapy , Exercise Therapy , Adolescent , Diabetes Mellitus, Type 1/blood , Diabetes Mellitus, Type 1/diet therapy , Diabetes Mellitus, Type 1/drug therapy , Female , Humans , Insulin/therapeutic use , Insulin, Isophane/therapeutic use , MaleABSTRACT
Compliance with blood glucose monitoring was studied in 18 children with type 1 diabetes. Using specially equipped blood glucose reflectance meters, children monitored their blood glucose levels, with and without knowledge of the meter's memory capability. Poor compliance, as exhibited by fabricated test results (40%) and failure to record test results (18%), occurred in a significant proportion of children. Further research is needed to explore reasons for such behavior and to suggest strategies for improving compliance.
Subject(s)
Blood Glucose/analysis , Diabetes Mellitus, Type 1/blood , Patient Compliance , Adolescent , Adult , Diabetes Mellitus, Type 1/psychology , Female , Humans , Male , Monitoring, Physiologic/instrumentation , Psychology, Adolescent , Self CareABSTRACT
Sixteen subjects with insulin-dependent diabetes mellitus were studied to determine whether changes in plasma lipids and apolipoproteins follow intensified control using preprandial doses of regular insulin with an additional dose of NPH insulin before bedtime. The mean total dialy dose of insulin was increased from 1.03 +/- 0.09 to 1.17 +/- 0.44 units/kg throughout the six-month period. Levels of HDL-cholesterol and apolipoprotein A-I increased without significant changes in hemoglobin A1 (HbA1), triglyceride, or cholesterol. These findings suggest that increases in HDL-cholesterol and apolipoprotein A-I were a result of the intensified insulin delivery.
