title: Impact of Physical Activity on Glycemic Control and Prevalence of Cardiovascular Risk Factors in Adults With Type 1 Diabetes: A Cross-sectional Multicenter Study of 18,028 Patients.
abstract: OBJECTIVE
  Physical activity (PA) can improve cardiovascular risk in the general population and in patients with type 2 diabetes. Studies also indicate an HbA(1c)-lowering effect in patients with type 2 diabetes. Since reports in patients with type 1 diabetes are scarce, this analysis aimed to investigate whether there is an association between PA and glycemic control or cardiovascular risk in subjects with type 1 diabetes.
  
  
  METHODS
  A total of 18,028 adults (≥18 to <80 years of age) from Germany and Austria with type 1 diabetes from the Diabetes-Patienten-Verlaufsdokumentation (DPV) database were included. Patients were stratified according to their self-reported frequency of PA (PA0, inactive; PA1, one to two times per week; PA2, more than two times per week). Multivariable regression models were applied for glycemic control, diabetes-related comorbidities, and cardiovascular risk factors. Data were adjusted for sex, age, and diabetes duration. P values for trend were given. SAS 9.4 was used for statistical analysis.
  
  
  RESULTS
  An inverse association between PA and HbA(1c), diabetic ketoacidosis, BMI, dyslipidemia (all P < 0.0001), and hypertension (P = 0.0150), as well as between PA and retinopathy or microalbuminuria (both P < 0.0001), was present. Severe hypoglycemia (assistance required) did not differ in PA groups (P = 0.8989), whereas severe hypoglycemia with coma was inversely associated with PA (P < 0.0001).
  
  
  CONCLUSIONS
  PA seemed to be beneficial with respect to glycemic control, diabetes-related comorbidities, and cardiovascular risk factors without an increase of adverse events. Hence, our data underscore the recommendation for subjects with type 1 diabetes to perform regular PA.
authors.affiliation: Institute of Epidemiology and Medical Biometry, ZIBMT, German Center for Diabetes Research (DZD), University of Ulm, Ulm, Germany barbara.bohn@uni-ulm.de.
authors.forename: Barbara
authors.initials: B
authors.lastname: Bohn
authors.affiliation: Centre for Paediatrics, Medical Clinic Leverkusen, Leverkusen, Germany.
authors.forename: Antje
authors.initials: A
authors.lastname: Herbst
authors.affiliation: Diabetes Center, Clinic Tettnang, Tettnang, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Pfeifer
authors.affiliation: DZFO, Diabetes Centre Forchheim, Forchheim, Germany.
authors.forename: Dietmar
authors.initials: D
authors.lastname: Krakow
authors.affiliation: Center for Internal Medicine, Endocrinology and Diabetology, Schwerin Hospital, Schwerin, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Zimny
authors.affiliation: Diabetes Center, Augsburg Clinical Center, Augsburg, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Kopp
authors.affiliation: Department of Internal Medicine I, Medical University of Innsbruck, Innsbruck, Austria.
authors.forename: Andreas
authors.initials: A
authors.lastname: Melmer
authors.affiliation: Division of Sports and Rehabilitation Medicine, Department of Internal Medicine II, University of Ulm, Ulm, Germany.
authors.forename: Jürgen M
authors.initials: JM
authors.lastname: Steinacker
authors.affiliation: Institute of Epidemiology and Medical Biometry, ZIBMT, German Center for Diabetes Research (DZD), University of Ulm, Ulm, Germany.
authors.forename: Reinhard W
authors.initials: RW
authors.lastname: Holl
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001317:Austria / Q000453:epidemiology; D001786:Blood Glucose / Q000378:metabolism; D016208:Databases, Factual; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000517:prevention & control*; D003925:Diabetic Angiopathies / Q000097:blood / Q000453:epidemiology / Q000517:prevention & control*; D016883:Diabetic Ketoacidosis / Q000097:blood / Q000453:epidemiology / Q000517:prevention & control; D050171:Dyslipidemias / Q000097:blood / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control; D015444:Exercise / Q000502:physiology*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000453:epidemiology / Q000517:prevention & control; D007003:Hypoglycemia / Q000097:blood / Q000453:epidemiology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin