title: Leisure time physical activity is associated with poor glycemic control in type 1 diabetic women: the FinnDiane study.
abstract: OBJECTIVE
  We studied the association between leisure time physical activity (LTPA) and glycemic control, insulin dose, and estimated glucose disposal rate (eGDR) in type 1 diabetes.
  
  
  METHODS
  This is a cross-sectional study of 1,030 type 1 diabetic patients participating in the Finnish Diabetic Nephropathy Study, a nationwide multicenter study. LTPA was assessed by a validated 12-month questionnaire and expressed in metabolic equivalent (MET) units. Patients were grouped as sedentary (LTPA <10 MET h/week, n = 247), moderately active (LTPA 10-40 MET h/week, n = 568), and active (LTPA >40 MET h/week, n = 215). Outcome measures were HbA(1c), insulin dose, and eGDR (estimate of insulin sensitivity based on waist-to-hip ratio, hypertension, and HbA(1c)).
  
  
  RESULTS
  LTPA correlated with HbA(1c) in women (r = -0.12, P = 0.007) but not in men (r = -0.03, P = 0.592). Sedentary women had higher HbA(1c) than moderately active and active women: 8.8 +/- 1.4% vs. 8.3 +/- 1.4% vs. 8.3 +/- 1.4% (P = 0.004), whereas HbA(1c) in men was 8.4 +/- 1.3% vs. 8.2 +/- 1.4% vs. 8.2 +/- 1.3% (P = 0.774), respectively. In men, insulin doses were 0.74 +/- 0.21 vs. 0.71 +/- 0.20 vs. 0.68 +/- 0.23 IU . kg(-1) . 24 h(-1) (P = 0.003). In both sexes, sedentary patients had lower eGDRs than active patients [median (interquartile range) 5.5 (4.0-8.2) vs. 6.8 (4.7-8.8) vs. 6.7 (4.6-8.6) mg . kg(-1) . min(-1); P < 0.01 for sedentary vs. others]. Age, obesity, smoking, insulin dose, social class, diabetic nephropathy, or cardiovascular disease did not explain the results.
  
  
  CONCLUSIONS
  Low levels of LTPA were associated with poor glycemic control in type 1 diabetic women. Men seem to use less insulin when physically active. Increased LTPA levels were associated with increased estimated insulin sensitivity. Longitudinal studies are needed to further clarify the effects of LTPA on type 1 diabetes.
authors.affiliation: Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum Helsinki, University of Helsinki, Haartmaninkatu 8, P.O. Box 63, 00014 Helsinki, Finland.
authors.forename: Johan
authors.initials: J
authors.lastname: Wadén
authors.forename: Heikki
authors.initials: H
authors.lastname: Tikkanen
authors.forename: Carol
authors.initials: C
authors.lastname: Forsblom
authors.forename: Johan
authors.initials: J
authors.lastname: Fagerudd
authors.forename: Kim
authors.initials: K
authors.lastname: Pettersson-Fernholm
authors.forename: Timo
authors.initials: T
authors.lastname: Lakka
authors.forename: Mikael
authors.initials: M
authors.lastname: Riska
authors.forename: Per-Henrik
authors.initials: PH
authors.lastname: Groop
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000503:physiopathology*; D003925:Diabetic Angiopathies / Q000453:epidemiology; D003928:Diabetic Nephropathies / Q000453:epidemiology; D003930:Diabetic Retinopathy / Q000453:epidemiology; D015444:Exercise; D005260:Female; D005387:Finland; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007899:Leisure Activities; D008019:Life Style; D008297:Male; D015203:Reproducibility of Results; D012727:Sex Characteristics; D011795:Surveys and Questionnaires
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin