Skip to main content

Advertisement

Log in

Physical Activity in Youth With Type 1 Diabetes: a Review

  • Psychosocial Aspects (S Jaser and KK Hood, Section Editors)
  • Published:
Current Diabetes Reports Aims and scope Submit manuscript

Abstract

Youth with type 1 diabetes are at risk for developing cardiovascular disease, and regular physical activity is strongly recommended as one strategy for prevention, as well as for good glycemic control. Despite recommendations, families in this pediatric population face unique barriers to physical activity, including fear of hypoglycemia. Moreover, families are not routinely counseled in the specific health and psychosocial benefits of following physical activity recommendations for youth with type 1 diabetes. To bridge this gap, the recent literature regarding physical activity in children with type 1 diabetes is reviewed with particular focus on young children. A discussion of the limitations of the current body of research, and recommendations for objectively measured physical activity are provided. Specific recommendations for clinical practice are given, including provider endorsements for regular physical activity for longer than 60 minutes, at least three times a week.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: •• Of major importance

  1. Pettitt D et al. Prevalence of diabetes in U.S. youth in 2009: the SEARCH for diabetes in youth study. Diabetes Care. 2014;37(2):402–8.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Dahlquist G, Nystrom L, Patterson C. Incidence of type 1 diabetes in Sweden among individual aged 0–34 years, 1983–2007: an analysis of time trends. Diabetes Care. 2011;34(8):1754–9.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Beraki A et al. Increase in physical activity is associated with lower HbA1c levels in children and adolescents with type 1 diabetes: results from a cross-sectional study based on the Swedish pediatric diabetes quality registry (SWEDIABKIDS). Diabetes Res Clin Pract. 2014;105(1):119–25.

    Article  CAS  PubMed  Google Scholar 

  4. Marliss EB, Vranic M. Intense exercise has unique effects on both insulin release and its roles in glucoregulation: implications for diabetes. Diabetes. 2002;51 Suppl 1:S271–83.

    Article  CAS  PubMed  Google Scholar 

  5. Miculis CP, De Campos W, da Silva Boguszweski MC. Correlation Between Glycemic Control and Physical Activity Level in Adolescents and Children With Type 1 Diabetes. J Phys Act Health. 2015;12(2):232–7.

    Article  PubMed  Google Scholar 

  6. American Diabetes Association, Children and adolescents. Section 11. Diabetes Care. 2015;38 Suppl: p. S70-6.

  7. Baird AA, Silver SH, Veague HB. Cognitive control reduces sensitivity to relational aggression among adolescent girls. Soc Neurosci. 2010;5(5-6):519–32.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Leclair E, de Kerdanet M, Riddell M, Heyman E, et al. Type 1 diabetes and physical activity in children and adolescents. J Diabetes Metab. 2013;S10:004. doi:10.4172/2155-6156.S10-004.

  9. Quirk H et al. Physical activity interventions in children and young people with type 1 diabetes mellitus: a systematic review with meta-analysis. Diabet Med. 2014;31(10):1163–73. This meta-analysis provides a thorough review and quantitative analysis of 26 physical activity intervention studies for youth with type 1 diabetes.

    Article  CAS  PubMed  Google Scholar 

  10. Copeland KC et al. Management of newly diagnosed type 2 diabetes mellitus (T2DM) in children and adolescents. Pediatrics. 2013;131(2):364–82.

    Article  PubMed  Google Scholar 

  11. Trost SG. Measurement of physical activity in children and adolescents. Am J Lifestyle Med. 2007;1(4):299–314.

    Article  Google Scholar 

  12. Kaskoun MC, Johnson RK, Goran MI. Comparison of energy intake by semiquantitative food-frequency questionnaire with total energy expenditure by the doubly labeled water method in young children. Am J Clin Nutr. 1994;60(1):43.

    CAS  PubMed  Google Scholar 

  13. Ruiz RM et al. A novel approach to characterize physical activity patterns in preschool-aged children. Obesity (Silver Spring). 2013;21(11):2197–203.

    Article  Google Scholar 

  14. Oliver M et al. Pedometer accuracy in physical activity assessment of preschool children. J Sci Med Sport. 2007;10:303–10.

    Article  PubMed  Google Scholar 

  15. Clemes SA, Biddle SJH. The use of pedometers for monitoring physical activity in children and adolescents: measurement considerations. J Phys Act Health. 2013;10:249–62.

    Article  PubMed  Google Scholar 

  16. Cardon G, De Bourdeaudhuji I. Comparison of pedometer and accelerometer measures of physical activity in preschool children. Pediatr Exerc Sci. 2007;19:205–14.

    Article  PubMed  Google Scholar 

  17. Lubans DR, Morgan PJ, Tudor-Locke C. A systematic review of studies using pedometers to promote physical activity among youth. Prev Med. 2009;4:307–15.

    Article  Google Scholar 

  18. American Academy of Pediatrics, American Public Health Association, and National Resource Center for Health and Safety in Child Care and Early Education. Caring for our children: national health and safety performance standards; guidelines for early care and education programs, Elk Grove Village, IL: American Academy of Pediatrics. 3rd ed. Washington: American Public Health Association; 2011.

    Google Scholar 

  19. Strong WB et al. Evidence based physical activity for school-age youth. J Pediatr. 2005;146(6):732–7.

    Article  PubMed  Google Scholar 

  20. Janssen I, Leblanc AG. Systematic review of the health benefits of physical activity and fitness in school-aged children and youth. Int J Behav Nutr Phys Act. 2010;7:40.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Chimen M et al. What are the health benefits of physical activity in type 1 diabetes mellitus? A literature review. Diabetologia. 2012;55(3):542–51.

    Article  CAS  PubMed  Google Scholar 

  22. Zinman B et al. Physical activity/exercise and diabetes mellitus. Diabetes Care. 2003;26 Suppl 1:S73–7.

    PubMed  Google Scholar 

  23. Streisand R, Monaghan M. Young children with type 1 diabetes: challenges, research, and future directions. Curr Diab Rep. 2014;14(9):1–9.

    Article  Google Scholar 

  24. Walker RG et al. Sedentary time and screen-based sedentary behaviors of children with a chronic disease. Pediatr Exerc Sci. 2015;27(2):219–25.

    Article  PubMed  Google Scholar 

  25. Nguyen T et al. Fitness and physical activity in youth with type 1 diabetes mellitus in good or poor glycemic control. Pediatr Diabetes. 2015;16(1):48–57.

    Article  CAS  PubMed  Google Scholar 

  26. Sideraviciute S et al. The effect of long-term swimming program on glycemia control in 14–19-year-aged healthy girls and girls with type 1 diabetes mellitus. Medicina (Kaunas). 2006;42(6):513–8.

    Google Scholar 

  27. Wang YC et al. Improved glycemic control in adolescents with type 1 diabetes mellitus who attend diabetes camp. Pediatr Diabetes. 2008;9(1):29–34.

    Article  PubMed  Google Scholar 

  28. Aman J et al. Associations between physical activity, sedentary behavior, and glycemic control in a large cohort of adolescents with type 1 diabetes: the Hvidoere study group on childhood diabetes. Pediatr Diabetes. 2009;10(4):234–9.

    Article  CAS  PubMed  Google Scholar 

  29. McMahon SK et al. Glucose requirements to maintain euglycemia after moderate-intensity afternoon exercise in adolescents with type 1 diabetes are increased in a biphasic manner. J Clin Endocrinol Metab. 2007;92(3):963–8.

    Article  CAS  PubMed  Google Scholar 

  30. Bachmann S et al. Nocturnal hypoglycemia and physical activity in children with diabetes: new insights by continuous glucose monitoring and accelerometry, Diabetes Care. 2016.

    Google Scholar 

  31. Metcalf KM et al. Effects of moderate-to-vigorous intensity physical activity on overnight and next-day hypoglycemia in active adolescents with type 1 diabetes. Diabetes Care. 2014;37(5):1272–8.

    Article  PubMed  PubMed Central  Google Scholar 

  32. MacMillan F et al. A systematic review of physical activity and sedentary behavior intervention studies in youth with type 1 diabetes: study characteristics, intervention design, and efficacy. Pediatr Diabetes. 2014;15(3):175–89. This recent review provides a comprehensive overview of 11 randomized controlled trials of physical activity interventions for youth with type 1 diabetes.

  33. Ahn S, Fedewa AL. A meta-analysis of the relationship between children’s physical activity and mental health. J Pediatr Psychol. 2011;36(4):385–97.

    Article  PubMed  Google Scholar 

  34. Larun L et al. Exercise in prevention and treatment of anxiety and depression among children and young people. Cochrane Database Syst Rev. 2006;3:CD004691.

    PubMed  Google Scholar 

  35. Hood KK et al. Depressive symptoms in children and adolescents with type 1 diabetes: association with diabetes-specific characteristics. Diabetes Care. 2006;29(6):1389–91.

    Article  PubMed  Google Scholar 

  36. Toaff M et al. Glycemic control as a function of breakfast macronutrients and physical activity timing in young children with type 1 diabetes, Poster Presented at the Pediatric Academic Societies 2016 Meeting in Baltimore, MD. 2016.

    Google Scholar 

  37. Aouadi R et al. Aerobic training programs and glycemic control in diabetic children in relation to exercise frequency. J Sports Med Phys Fitness. 2011;51(3):393–400.

  38. Baevre H et al. Metabolic responses to physical training in young insulin-dependent diabetics. Scand J Clin Lab Invest. 1985;45(2):109–14.

  39. Campaigne BN et al. Effects of a physical activity program on metabolic control and cardiovascular fitness in children with insulin-dependent diabetes mellitus. Diabetes Care. 1984;7(1):57–62.

  40. Dahl-Jorgensen K et al. The effect of exercise on diabetic control and hemoglobin A1 (HbA1) in children. Acta Paediatr Scand Suppl. 1980;283:53–6.

  41. D'Hooge R, Hellinckx T, Van Laethem C, Stegen S, De Schepper J, Van Aken S, Dewolf D, Calders P. Influence of combined aerobic and resistance training on metabolic control, cardiovascular fitness and quality of life in adolescents with type 1 diabetes: a randomized controlled trial. Clin Rehabil. 2011;25(4):349–59.

  42. Faulkner MS, Michaliszyn SF, Hepworth JT. A personalized approach to exercise promotion in adolescents with type 1 diabetes. Pediatr Diabetes. 2010;11(3):166–74.

  43. Heyman E et al. Exercise training and cardiovascular risk factors in type 1 diabetic adolescent girls. Pediatr Exerc Sci. 2007;19(4):408–19.

  44. Huttunen NP et al. Effect of once-a-week training program on physical fitness and metabolic control in children with IDDM. Diabetes Care. 1989;12(10):737–40.

  45. Landt KW, et al. Effects of exercise training on insulin sensitivity in adolescents with type I diabetes. Diabetes

  46. Larsson Y et al. Functional Adaptation to Rigorous Training and Exercise in Diabetic and Nondiabetic Adolescents. J Appl Physiol. 1964;19:629–35.

  47. Larsson Y et al. Effect of Exercise on Blood-Lipids in Juvenile Diabetes. Lancet. 1964;1(7329):350–5.

  48. Maggio AB et al. Physical activity increases bone mineral density in children with type 1 diabetes. Med Sci Sports Exerc. 2012;44(7):1206–11.

  49. Marrero DG, Fremion AS, Golden MP. Improving compliance with exercise in adolescents with insulin-dependent diabetes mellitus: results of a self-motivated home exercise program. Pediatrics. 1988;81(4):519–25.

  50. Mosher PE et al. Aerobic circuit exercise training: effect on adolescents with well-controlled insulindependent diabetes mellitus. Arch Phys Med Rehabil. 1998;79(6):652–7.

  51. Newton KH, Wiltshire EJ, Elley CR. Pedometers and text messaging to increase physical activity: randomized controlled trial of adolescents with type 1 diabetes. Diabetes Care. 2009;32(5):813–5.

  52. Rowland TW et al. Glycemic control with physical training in insulin-dependent diabetes mellitus. Am J Dis Child. 1985;139(3):307–10.

  53. Ruzic L, Sporis G, Matkovic BR. High volume-low intensity exercise camp and glycemic control in diabetic children. J Paediatr Child Health. 2008;44:122–8.

  54. Salem MA et al. Is exercise a therapeutic tool for improvement of cardiovascular risk factors in adolescents with type 1 diabetes mellitus? A randomised controlled trial. Diabetol Metab Syndr. 2010;2(1):47.

  55. Seeger JP et al. Exercise training improves physical fitness and vascular function in children with type 1 diabetes. Diabetes Obes Metab. 2011;13(4):382–4.

  56. Stratton R et al. Improved glycemic control after supervised 8-wk exercise program in insulin-dependent diabetic adolescents. Diabetes Care. 1987;10(5):589–93.

  57. Tomar RH, Hashim MH, Al-Qahtani MH. Effects of a 12-week aerobic training on glycemic control in type 2 diabetes mellitus male patients. Saudi Med J. 2013;34(7):757–9.

  58. Tunar M et al. The effects of Pilates on metabolic control and physical performance in adolescents with type 1 diabetes mellitus. J Diabetes Complicat. 2012;26(4):348–51.

  59. Wong CH et al. Effects of a home-based aerobic exercise programme in children with type 1 diabetes mellitus. J Clin Nurs. 2011;20(5-6):681–91.

  60. Woo J et al. Antioxidant enzyme activities and DNA damage in children with type 1 diabetes mellitus after 12 weeks of exercise. Acta Paediatr. 2010;99(8):1263–8.

  61. Huttunen NP et al. Effect of once-a-week training program on physical fitness and metabolic control in children with IDDM. Diabetes Care. 1989;12(10):737–40.

    Article  CAS  PubMed  Google Scholar 

  62. Adamo KB et al. A comparison of indirect versus direct measures for assessing physical activity in the pediatric population: a systematic review. Int J Pediatr Obes. 2009;4(1):2–27.

    Article  PubMed  Google Scholar 

  63. Kennedy A et al. Does exercise improve glycaemic control in type 1 diabetes? a systematic review and meta-analysis. PLoS One. 2013;8(3):e58861.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  64. Dwyer GM et al. What do parents and preschool staff tell us about young children’s physical activity: a qualitative study. Int J Behav Nutr Phys Act. 2008;5(1):1–11.

    Article  Google Scholar 

  65. Verschuren O et al. Identification of facilitators and barriers to physical activity in children and adolescents with cerebral palsy. J Pediatr. 2012;161(3):488–94.

    Article  PubMed  Google Scholar 

  66. Yardley J et al. Vigorous intensity exercise for glycemic control in patients with type 1 diabetes. Can J Diabetes. 2013;37(6):427–32.

    Article  PubMed  Google Scholar 

  67. Johnson S et al. Hypoglycaemia, fear of hypoglycaemia and quality of life in children with type 1 diabetes and their parents. Diabet Med. 2013;30(9):1126–31.

    Article  CAS  PubMed  Google Scholar 

  68. Van der Horst K et al. A brief review on correlates of physical activity and sedentariness in youth. Med Sci Sports Exerc. 2007;39(8):1241–50.

    Article  Google Scholar 

  69. Hardman K. Physical education in schools: a global perspective. Kinesiology. 2008;40(1):15–28.

    Google Scholar 

  70. Alexander SA, Frohlich KL, Fusco C. Playing for health? Revisiting health promotion to examine the emerging public health position on children’s play. Health Promot Int. 2014;29(1):155–64.

    Article  PubMed  Google Scholar 

  71. Trost SG, Rosenkranz RR, Dzewaltowski D. Physical activity levels among children attending after-school programs, Medicine & Science in Sports & Exercise. 2008;40(4):622–9.

  72. Tremblay MS et al. Position statement on active outdoor play. Int J Environ Res Public Health. 2015;12(6):6475–505.

    Article  PubMed  PubMed Central  Google Scholar 

  73. Sallis JF, Prochaska JJ, Taylor WC. A review of correlates of physical activity of children and adolescents. Med Sci Sports Exerc. 2000;32(5):963–75.

    Article  CAS  PubMed  Google Scholar 

  74. Ryninks K et al. Attitudes to exercise and diabetes in young people with type 1 diabetes mellitus: a qualitative analysis. PLoS One. 2015;10(10):e0137562.

    Article  PubMed  PubMed Central  Google Scholar 

  75. Guicciardi M et al. Type 2 diabetes mellitus, physical activity, exercise self-efficacy, and body satisfaction. An application of the transtheoretical model in older adults. Health Psychol Behav Med. 2014;2(1):748–58.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Carrie Tully.

Ethics declarations

Conflict of Interest

Carrie Tully, Laura Aronow, Eleanor Mackey, and Randi Streisand declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Psychosocial Aspects

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tully, C., Aronow, L., Mackey, E. et al. Physical Activity in Youth With Type 1 Diabetes: a Review. Curr Diab Rep 16, 85 (2016). https://doi.org/10.1007/s11892-016-0779-6

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11892-016-0779-6

Keywords

Navigation