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Published in: BMC Endocrine Disorders 1/2013

Open Access 01-12-2013 | Research article

Effects of physical activity on the development and progression of microvascular complications in type 1 diabetes: retrospective analysis of the DCCT study

Authors: Caroline BT Makura, Krishnarajah Nirantharakumar, Alan J Girling, Ponnusamy Saravanan, Parth Narendran

Published in: BMC Endocrine Disorders | Issue 1/2013

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Abstract

Background

To examine the effects of physical activity on the development and progression of microvascular complications in patients with type 1 diabetes.

Methods

A retrospective analysis of data from the Diabetes Control and Complications trial was undertaken. Physical activity data was collected at baseline for each of 1441 recruits, converted to metabolic equivalent of task values, and categorised according to the American College of Sports Medicine recommendations. The rates of development/progression of diabetic retinopathy, nephropathy and neuropathy were compared in those who achieved over twice recommended, up to twice recommended, and less than recommended metabolic equivalent of task levels of activity. The DCCT study had a mean duration of follow up of 6.5 years ending in 1993.

Results

A total of 271 subjects had a sustained three-step progression in diabetic retinopathy. The rates of development or progression of retinopathy showed no significant association with physical activity level. The number of outcomes for nephropathy and neuropathy were small and there was no significant association with physical activity level.

Conclusions

We found no evidence that physical activity improves microvascular outcomes in type 1 diabetes. However we demonstrate no evidence of harm. We suggest that physical activity continues to play an important role in the management of type 1 diabetes.
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Literature
1.
go back to reference LaPorte RE, Dorman JS, Tajima N: Pittsburgh insulin-dependent diabetes mellitus morbidity and mortality study: physical activity and diabetic complications. Pediatrics. 1986, 78: 1027-1033.PubMed LaPorte RE, Dorman JS, Tajima N: Pittsburgh insulin-dependent diabetes mellitus morbidity and mortality study: physical activity and diabetic complications. Pediatrics. 1986, 78: 1027-1033.PubMed
2.
go back to reference Moy CS, Songer TJ, LaPorte RE: Insulin-dependent diabetes mellitus, physical activity, and death. Am J Epidemiol. 1993, 137: 74-81.PubMed Moy CS, Songer TJ, LaPorte RE: Insulin-dependent diabetes mellitus, physical activity, and death. Am J Epidemiol. 1993, 137: 74-81.PubMed
3.
go back to reference Chimen M, Kennedy A, Nirantharakumar K: What are the health benefits of physical activity in type 1 diabetes mellitus? A literature review. Diabetologia. 2012, 55 (3): 542-551. 10.1007/s00125-011-2403-2.CrossRefPubMed Chimen M, Kennedy A, Nirantharakumar K: What are the health benefits of physical activity in type 1 diabetes mellitus? A literature review. Diabetologia. 2012, 55 (3): 542-551. 10.1007/s00125-011-2403-2.CrossRefPubMed
4.
go back to reference Luckie R, Leese G, McAlpine R: Fear of visual loss in patients with diabetes: results of the prevalence of diabetic eye disease in Tayside, Scotland (P-DETS) study. Diabet Med. 2007, 24 (10): 1086-1092. 10.1111/j.1464-5491.2007.02180.x.CrossRefPubMed Luckie R, Leese G, McAlpine R: Fear of visual loss in patients with diabetes: results of the prevalence of diabetic eye disease in Tayside, Scotland (P-DETS) study. Diabet Med. 2007, 24 (10): 1086-1092. 10.1111/j.1464-5491.2007.02180.x.CrossRefPubMed
5.
go back to reference Taylor EP, Crawford JR, Gold AE: Design and development of a scale measuring fear of complications in type 1 diabetes. Diabetes Metab Res Rev. 2005, 21 (3): 264-270. 10.1002/dmrr.524.CrossRefPubMed Taylor EP, Crawford JR, Gold AE: Design and development of a scale measuring fear of complications in type 1 diabetes. Diabetes Metab Res Rev. 2005, 21 (3): 264-270. 10.1002/dmrr.524.CrossRefPubMed
6.
go back to reference Waden J, Forsblom C, Thorn LM: Physical activity and diabetes complications in patients with type 1 diabetes: the Finnish Diabetic Nephropathy (FinnDiane) Study. Diabetes care. 2008, 31: 230-232.CrossRefPubMed Waden J, Forsblom C, Thorn LM: Physical activity and diabetes complications in patients with type 1 diabetes: the Finnish Diabetic Nephropathy (FinnDiane) Study. Diabetes care. 2008, 31: 230-232.CrossRefPubMed
7.
go back to reference Kriska AM, LaPorte RE, Patrick SL: The association of physical activity and diabetic complications in individuals with insulin-dependent diabetes mellitus: the Epidemiology of Diabetes Complications Study–VII. J Clin Epidemiol. 1991, 44: 1207-1214. 10.1016/0895-4356(91)90153-Z.CrossRefPubMed Kriska AM, LaPorte RE, Patrick SL: The association of physical activity and diabetic complications in individuals with insulin-dependent diabetes mellitus: the Epidemiology of Diabetes Complications Study–VII. J Clin Epidemiol. 1991, 44: 1207-1214. 10.1016/0895-4356(91)90153-Z.CrossRefPubMed
8.
go back to reference The Diabetes Control and Complications Trial Research Group: The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993, 329: 977-986.CrossRef The Diabetes Control and Complications Trial Research Group: The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993, 329: 977-986.CrossRef
9.
go back to reference Ainsworth BE, Haskell WL, Whitt MC: Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc. 2000, 32 (Suppl): S498-S516.CrossRefPubMed Ainsworth BE, Haskell WL, Whitt MC: Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc. 2000, 32 (Suppl): S498-S516.CrossRefPubMed
10.
go back to reference Haskell WL, Lee IM, Pate RR: Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc. 2007, 39 (8): 1423-1434. 10.1249/mss.0b013e3180616b27.CrossRefPubMed Haskell WL, Lee IM, Pate RR: Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc. 2007, 39 (8): 1423-1434. 10.1249/mss.0b013e3180616b27.CrossRefPubMed
11.
go back to reference The Diabetes Control and Complications Trial Research Group: The relationship of glycemic exposure (HbA1c) to the risk of development and progression of retinopathy in the Diabetes Control and Complications Trial. Diabetes. 1995, 44: 968-983.CrossRef The Diabetes Control and Complications Trial Research Group: The relationship of glycemic exposure (HbA1c) to the risk of development and progression of retinopathy in the Diabetes Control and Complications Trial. Diabetes. 1995, 44: 968-983.CrossRef
12.
go back to reference Molitch ME, Steffes MW, Cleary PA: Baseline analysis of renal function in the Diabetes Control and Complications Trial. The Diabetes Control and Complications Trial Research Group [corrected].[Erratum appears in Kidney Int 1993 May;43(5):1196]. Kidney Int. 1993, 43 (3): 668-674. 10.1038/ki.1993.96.CrossRefPubMed Molitch ME, Steffes MW, Cleary PA: Baseline analysis of renal function in the Diabetes Control and Complications Trial. The Diabetes Control and Complications Trial Research Group [corrected].[Erratum appears in Kidney Int 1993 May;43(5):1196]. Kidney Int. 1993, 43 (3): 668-674. 10.1038/ki.1993.96.CrossRefPubMed
13.
go back to reference The Diabetes Control and Complications (DCCT) Research Group: Effect of intensive therapy on the development and progression of diabetic nephropathy in the Diabetes Control and Complications Trial. Kidney Int. 1995, 47 (6): 1703-1720.CrossRef The Diabetes Control and Complications (DCCT) Research Group: Effect of intensive therapy on the development and progression of diabetic nephropathy in the Diabetes Control and Complications Trial. Kidney Int. 1995, 47 (6): 1703-1720.CrossRef
14.
go back to reference The effect of intensive diabetes therapy on the development and progression of neuropathy: The Diabetes Control and Complications Trial Research Group. Ann Intern Med. 1995, 122 (8): 561-568.CrossRef The effect of intensive diabetes therapy on the development and progression of neuropathy: The Diabetes Control and Complications Trial Research Group. Ann Intern Med. 1995, 122 (8): 561-568.CrossRef
15.
go back to reference Heath GW, Parra DC, Sarmiento OL: Evidence-based intervention in physical activity: lessons from around the world. Lancet. 2012, 380 (9838): 272-281. 10.1016/S0140-6736(12)60816-2.CrossRefPubMed Heath GW, Parra DC, Sarmiento OL: Evidence-based intervention in physical activity: lessons from around the world. Lancet. 2012, 380 (9838): 272-281. 10.1016/S0140-6736(12)60816-2.CrossRefPubMed
16.
go back to reference Tesfaye S, Chaturvedi N, Eaton SE: Vascular risk factors and diabetic neuropathy. N Engl J Med. 2005, 352 (4): 341-350. 10.1056/NEJMoa032782.CrossRefPubMed Tesfaye S, Chaturvedi N, Eaton SE: Vascular risk factors and diabetic neuropathy. N Engl J Med. 2005, 352 (4): 341-350. 10.1056/NEJMoa032782.CrossRefPubMed
17.
go back to reference Marshall SM, Flyvbjerg A: Prevention and early detection of vascular complications of diabetes. BMJ. 2006, 333 (7566): 475-480. 10.1136/bmj.38922.650521.80.CrossRefPubMedPubMedCentral Marshall SM, Flyvbjerg A: Prevention and early detection of vascular complications of diabetes. BMJ. 2006, 333 (7566): 475-480. 10.1136/bmj.38922.650521.80.CrossRefPubMedPubMedCentral
18.
go back to reference Marcovecchio ML, Tossavainen PH, Dunger DB: Prevention and treatment of microvascular disease in childhood type 1 diabetes. Br Med Bull. 2010, 94: 145-164. 10.1093/bmb/ldp053.CrossRefPubMed Marcovecchio ML, Tossavainen PH, Dunger DB: Prevention and treatment of microvascular disease in childhood type 1 diabetes. Br Med Bull. 2010, 94: 145-164. 10.1093/bmb/ldp053.CrossRefPubMed
19.
go back to reference Campaigne BN, Gilliam TB, Spencer ML: Effects of a physical activity program on metabolic control and cardiovascular fitness in children with insulindependent diabetes mellitus. Diabetes Care. 1984, 7: 57-62. 10.2337/diacare.7.1.57.CrossRefPubMed Campaigne BN, Gilliam TB, Spencer ML: Effects of a physical activity program on metabolic control and cardiovascular fitness in children with insulindependent diabetes mellitus. Diabetes Care. 1984, 7: 57-62. 10.2337/diacare.7.1.57.CrossRefPubMed
20.
go back to reference Perry TL, Mann JI, Lewis-Barned NJ: Lifestyle intervention in people with insulin dependent diabetes mellitus (IDDM). Eur J Clin Nutr. 1997, 51: 757-763. 10.1038/sj.ejcn.1600478.CrossRefPubMed Perry TL, Mann JI, Lewis-Barned NJ: Lifestyle intervention in people with insulin dependent diabetes mellitus (IDDM). Eur J Clin Nutr. 1997, 51: 757-763. 10.1038/sj.ejcn.1600478.CrossRefPubMed
21.
go back to reference Laaksonen DE, Atalay M, Niskanen LK: Aerobic exercise and the lipid profile in type 1 diabetic men: a randomized controlled trial. Med Sci Sports Exerc. 2000, 32: 1541-1548.CrossRefPubMed Laaksonen DE, Atalay M, Niskanen LK: Aerobic exercise and the lipid profile in type 1 diabetic men: a randomized controlled trial. Med Sci Sports Exerc. 2000, 32: 1541-1548.CrossRefPubMed
Metadata
Title
Effects of physical activity on the development and progression of microvascular complications in type 1 diabetes: retrospective analysis of the DCCT study
Authors
Caroline BT Makura
Krishnarajah Nirantharakumar
Alan J Girling
Ponnusamy Saravanan
Parth Narendran
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Endocrine Disorders / Issue 1/2013
Electronic ISSN: 1472-6823
DOI
https://doi.org/10.1186/1472-6823-13-37

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