Exercise in Adolescents With Type 1 Diabetes

Metabolic Effects of Exercise in Adolescents With Type 1 Diabetes

Regular physical activity is an important part of diabetes management in adolescents with type 1 diabetes (T1D). Increased physical activity has several beneficial effects such as improved lipid profile, insulin sensitivity and quality of life. In addition, a reduced HbA1c is often seen in association to increased physical activity. However, the effect on glycemic control and the acute glycemic response seems to differs between different types of exercise. This issue is poorly studied in adolescents with T1D and the mechanism behind this is not fully understood.

The primary aim of this study was to compare the acute effects on glycemia of resistance and two aerobic continuous and intermittent exercise bouts in adolescents with type 1 diabetes. Secondarily, the investigators want to compare the different exercise according to hormonal changes and expression of mRNA in muscle.

At a baseline visit the participants was tested for maximal oxygen consumption (pVO2peak) and maximal strength (1-RM). The study participants then performed three exercise bouts and one control session (resting), each on 45 minutes, in a randomized order. Measurement was performed during and after the exercise.

Study Overview

• Status: Active, not recruiting
• Conditions: Type 1 Diabetes
• Intervention / Treatment: Other: Exercise bouts

• Study Type: Interventional
• Enrollment (Actual): 8
• Phase: Not Applicable

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 16 years to 18 years (Child, Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: Male

Description

Inclusion Criteria:

• Male
• Type 1 diabetes
• HbA1c < 65 mol/mol at inclusion
• Regularly performing physical activity
• Aged 16-18 years old

Exclusion Criteria:

• Less than 0.5 U/kg in insulin requirements
• Duration of diabetes less than one year.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Basic Science
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Exercise; All subject will perform three different exercise bouts and one control session.	Other: Exercise bouts; Each subject performed three bouts with 45 minutes of exercise (continuous exercise, intermittent exercise and resistance exercise) in a randomized order. In addition a control session were performed where the subjects sat on a chair for 45 minutes.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in plasma glucose during exercise and recovery	Plasma glucose (mmol/l) measured by an hand-held glucometer	Plasma glucose were measured at 5 minutes before and at start of the bouts. Thereafter glucose was measured at 5,10,15,30 and 45 minutes during exercise. In addition glucose were measured at 15, 30, 45 and 60 minutes during the initial recovery period.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Sensor glucose	Blinded continuous glucose measurement (mmol/l) were used to measure sensor glucose	Blinded continuous glucose measurement was started when the exercise bouts were finished and were there after used during the next 22 hours (until the next morning at 08:00 am).
Changes in levels of hormones during exercise and recovery	Insulin, glucagon, catecholamines, insulin-like growth factor I, cortisol, growth hormone	Serum samples were collected at baseline and after 15 ,30 ,45 of exercise and after 15 minutes of recovery for later analysis
Change in levels of messenger ribonucleic acid (mRNA) between baseline and exercise.	mRNA levels were analyzed with microarray from muscle biopsies and compared between exercise bouts and baseline.	One biopsy (baseline) were collected approximately one week before the first exercise bout and thereafter one biopsy appr. 60 minutes after each exercise bout.
Comparisons of levels of messenger ribonucleic acid (mRNA) between different exercise bouts.	mRNA levels were analyzed with microarray from muscle biopsies and compared between the exercise bouts.	One biopsy was collected appr. 60 minutes after each exercise bout.
Change in heart rate during exercise.	Heart rate (beats per minute) were monitored by pulse oximetry and compared between the exercise bouts.	Heart rate was monitored continuously during exercise from 5 minutes before start of exercise until the bout was finished (time-point 45 minutes).
Change in hemoglobin saturation during exercise.	Hemoglobin saturation (SpO2 %) was monitored by pulse oximetry and compared between the exercise bouts.	Hemoglobin saturation was measured continuously during exercise from 5 minutes before start of exercise until the bout was finished (time-point 45 minutes).
Change in cardiac output.	Cardiac output (L/min) was measured with Physioflow and compared between the exercise bouts.	Cardiac output was measured continuously during exercise from 5 minutes before start of exercise until the bout was finished (time-point 45 minutes).

Collaborators and Investigators

• Sponsor: Region Örebro County
• Collaborators: Örebro University, Sweden
• Investigators: Study Chair: Fawzi Kadi, Professor, School of health Sciences, Örebro University, Sweden

Study record dates

Study Major Dates

• Study Start (Actual): March 1, 2014
• Primary Completion (Actual): June 27, 2016
• Study Completion (Anticipated): June 1, 2024

Study Registration Dates

• First Submitted: May 15, 2020
• First Submitted That Met QC Criteria: June 4, 2020
• First Posted (Actual): June 5, 2020

Study Record Updates

• Last Update Posted (Actual): October 31, 2022
• Last Update Submitted That Met QC Criteria: October 28, 2022
• Last Verified: March 1, 2021

More Information

Terms related to this study

• Keywords: Adolescents; Exercise; Type 1 diabetes
• Additional Relevant MeSH Terms: Glucose Metabolism Disorders; Metabolic Diseases; Immune System Diseases; Autoimmune Diseases; Endocrine System Diseases; Diabetes Mellitus; Diabetes Mellitus, Type 1
• Other Study ID Numbers: 251981

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No