Dataset Information

Daily energy expenditure, cardiorespiratory fitness and glycaemic control in people with type 1 diabetes.

ABSTRACT:

Objective

Encouraging daily physical activity improves cardiorespiratory fitness and many cardiovascular risk factors. However, increasing physical activity often creates a challenge for people with type 1 diabetes, because of difficulties maintaining euglycemia in the face of altered food intake and adjustments to insulin doses. Our aim was to examine the triangular relationship between glucose control measured by continuous glucose monitoring system (CGMS), objective measures of total daily energy expenditure (TEE) recorded by a multi-sensory monitoring device, and cardiorespiratory fitness (CRF), in free-living subjects with type 1 diabetes.

Research design and methods

Twenty-three individuals (12 women) with type 1 diabetes who were free from micro- and macrovascular complications were recruited. TEE and glucose control were monitored simultaneously for up to 12 days, using a multi-sensory device and CGMS respectively. CRF was recorded as V02 max from a maximal treadmill test with the Bruce protocol.

Results

Subjects (mean±SD) were aged 37±11 years, with BMI?=?26.5±5.1 kg.m?², HbA1c?=?7.7±1.3% (61±14 mmol/mol) and V02 max (ml.min?¹.kg?¹) ?=?39.9±8.4 (range 22.4-58.6). TEE (36.3±5.5 kcal.kg?¹.day?¹) was strongly associated with CRF(39.9±8.4 ml.min?¹.kg?¹) independently of sex (r?=?0.63, p<0.01). However, neither TEE (r?=?-0.20, p?=?0.36) nor CRF (r?=?-0.20, p?=?0.39; adjusted for sex), were significantly associated with mean glycaemia measured by CGMS.

Conclusion

Higher levels of energy expenditure (due to a more active lifestyle) are associated with increased cardiorespiratory fitness, but not necessarily better glycaemic control. Since increased levels of energy expenditure and good glycaemic control are both needed to protect against diabetes-related complications our data suggest they need to be achieved independently.

SUBMITTER: Valletta JJ

PROVIDER: S-EPMC4020853 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature

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Publications

Daily energy expenditure, cardiorespiratory fitness and glycaemic control in people with type 1 diabetes.

Valletta John Joseph JJ Chipperfield Andrew J AJ Clough Geraldine F GF Byrne Christopher D CD

PloS one 20140514 5

<h4>Objective</h4>Encouraging daily physical activity improves cardiorespiratory fitness and many cardiovascular risk factors. However, increasing physical activity often creates a challenge for people with type 1 diabetes, because of difficulties maintaining euglycemia in the face of altered food intake and adjustments to insulin doses. Our aim was to examine the triangular relationship between glucose control measured by continuous glucose monitoring system (CGMS), objective measures of total ...[more]

PMID: 24826899

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Project description:Aims/hypothesisThe aim of this work was to examine whether glycaemic control has improved in those with type 1 diabetes in Scotland between 2004 and 2016, and whether any trends differed by sociodemographic factors.MethodsWe analysed records from 30,717 people with type 1 diabetes, registered anytime between 2004 and 2016 in the national diabetes database, which contained repeated measures of HbA1c. An additive mixed regression model was used to estimate calendar time and other effects on HbA1c.ResultsOverall, median (IQR) HbA1c decreased from 72 (21) mmol/mol [8.7 (4.1)%] in 2004 to 68 (21) mmol/mol (8.4 [4.1]%) in 2016. However, all of the improvement across the period occurred in the latter 4 years: the regression model showed that the only period of significant change in HbA1c was 2012-2016 where there was a fall of 3 (95% CI 1.82, 3.43) mmol/mol. The largest reductions in HbA1c in this period were seen in children, from 69 (16) mmol/mol (8.5 [3.6]%) to 63 (14) mmol/mol (7.9 [3.4]%), and adolescents, from 75 (25) mmol/mol (9.0 [4.4]%) to 70 (23) mmol/mol (8.6 [4.3]%). Socioeconomic status (according to Scottish Index of Multiple Deprivation) affected the HbA1c values: from the regression model, the 20% of people living in the most-deprived areas had HbA1c levels on average 8.0 (95% CI 7.4, 8.9) mmol/mol higher than those of the 20% of people living in the least-deprived areas. However this difference did not change significantly over time. From the regression model HbA1c was on average 1.7 (95% CI 1.6, 1.8) mmol/mol higher in women than in men. This sex difference did not narrow over time.Conclusions/interpretationIn this high-income country, we identified a modest but important improvement in HbA1c since 2012 that was most marked in children and adolescents. These changes coincided with national initiatives to reduce HbA1c including an expansion of pump therapy. However, in most people, overall glycaemic control remains far from target levels and further improvement is badly needed, particularly in those from more-deprived areas.

Dataset Information

Daily energy expenditure, cardiorespiratory fitness and glycaemic control in people with type 1 diabetes.

Objective

Research design and methods

Results

Conclusion

Publications

Daily energy expenditure, cardiorespiratory fitness and glycaemic control in people with type 1 diabetes.

Similar Datasets

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