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).
OBJECTIVE
To evaluate the associations between physical activity (PA) and metabolic control, measured by glycated hemoglobin (HbA1c), in a large group of children and adolescents with type 1 diabetes.


METHODS
Cross-sectional analysis of data from 4655 patients, comparing HbA1c values with levels of physical activity. The data for the children and adolescents were obtained from the Swedish pediatric diabetes quality registry, SWEDIABKIDS. The patients were 7-18 years of age, had type 1 diabetes and were not in remission. Patients were grouped into five groups by frequency of PA.


RESULTS
Mean HbA1c level was higher in the least physically active groups (PA0: 8.8% ± 1.5 (72 ± 16 mmol/mol)) than in the most physically active groups (PA4: 7.7% ± 1.0 (60 ± 11 mmol/mol)) (p<0.001). An inverse dose-response association was found between PA and HbA1c (β: -0.30, 95% CI: -0.34 to -0.26, p<0.001). This association was found in both sexes and all age groups, apart from girls aged 7-10 years. Multiple regression analysis revealed that the relationship remained significant (β: -0.21, 95% CI: -0.25 to -0.18, p<0.001) when adjusted for possible confounding factors.


CONCLUSIONS
Physical activity seems to influence HbA1c levels in children and adolescents with type 1 diabetes. In clinical practice these patients should be recommended daily physical activity as a part of their treatment.
Linköping University, Linköping, Sweden.
Å
Å
Beraki
Clinical Epidemiology and Biostatistic Unit, Örebro University Hospital, Örebro, Sweden.
A
A
Magnuson
Department of Pediatrics, Örebro University Hospital, Örebro, Sweden; Department of Health and Clinical Science, Örebro University, Örebro, Sweden.
S
S
Särnblad
Department of Pediatrics, Örebro University Hospital, Örebro, Sweden; Department of Health and Clinical Science, Örebro University, Örebro, Sweden.
J
J
Åman
Department of Clinical and Experimental Medicine, Division of Pediatrics and Diabetes Research Centre, Linköping University, Linköping S-581 85, Sweden. Electronic address: ulf.samuelsson@lio.se.
U
U
Samuelsson
D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism*; D002648:Child; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000628:therapy; D015444:Exercise / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D008297:Male; D010372:Pediatrics; D012042:Registries; D013548:Sweden
D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
HbA1c; Metabolic control; Physical activity; Quality register