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Exercise might improve cardiovascular autonomic regulation in adolescents with type 1 diabetes

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Abstract

Considering that changes in exercise routines might have relevance in treatment of adolescents with type 1 diabetes mellitus, we sought to assess whether spontaneous modifications to weekly exercise habits might occur in these patients and whether such variations would be accompanied by alterations in autonomic profile. In this observational study, we examined 77 patients (age 15.0 ± 0.6 years.) who in addition to a tailored optimal insulin treatment were invited to perform at least 1 h a day of moderate, aerobic exercise, as suggested by recent guidelines. Patients were studied at baseline (T0) and after 15.8 ± 0.7 months (T1). They were divided into three subgroups according to increased, unchanged and diminished total estimated weekly METs between T0 and T1. Autonomic profile was evaluated by assessing spontaneous baroreflex gain and low-frequency oscillation in arterial pressure, using spectral analysis of RR and systolic arterial pressure time series. Insulin therapy and biochemical data were similar among the 3 groups at T0 and T1, while body mass index standard deviation score was slightly reduced (p < 0.04) and markers of autonomic performance were improved (alpha index, from 17 ± 1 to 20 ± 2 ms/mmHg, p < 0.002) in the group who increased the amount of exercise (from 1627 ± 250 to 3582 ± 448 METs min wt−1, p < 0.001). Furthermore, the change in total weekly METs significantly correlates with changes of key indices of autonomic regulation. The favourable autonomic effects of moderate increase in spontaneous exercise load suggest testing more formally this intervention in adolescents with type 1 diabetes.

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Abbreviations

BRS:

Baroreflex gain

CSII:

Continuous subcutaneous insulin infusion

HFRR :

High-frequency components of RR interval

LFRR :

Low-frequency components of RR interval

LFSAP :

Low-frequency component of systolic arterial pressure oscillations

MDI:

Multiple daily insulin injections

SAP:

Systolic arterial pressure

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Acknowledgments

We acknowledge the expert secretarial help of Giovanna Maccio’, Department of Clinical Sciences, University of Milano. We acknowledge partial financial support from Agenzia Spaziale Italiana (Disturbi Controllo Motorio e Cardiorespiratorio) and Fondo Italiano Ricerca Scientifica of Italian Research and University Ministry.

Conflict of interest

None to declare.

Author information

Authors and Affiliations

  1. IRCCS, Istituto Clinico Humanitas, Via Manzoni 56, 20089, Rozzano, Milano, Italy

    Daniela Lucini & Mara Malacarne

  2. CTNV, University of Milano, Via G.B. Grassi 74, 20157, Milano, Italy

    Daniela Lucini, Mara Malacarne, Federico Gervasi & Massimo Pagani

  3. Department of Clinical Sciences, University of Milano, Via G.B. Grassi 74, 20157, Milano, Italy

    Gian Vincenzo Zuccotti, Andrea Scaramuzza, Federico Gervasi & Massimo Pagani

  4. Department of Paediatrics, L Sacco Hospital, Milano, Italy

    Gian Vincenzo Zuccotti & Andrea Scaramuzza

Authors
  1. Daniela Lucini
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  2. Gian Vincenzo Zuccotti
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  3. Andrea Scaramuzza
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  4. Mara Malacarne
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  5. Federico Gervasi
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  6. Massimo Pagani
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Corresponding author

Correspondence to Daniela Lucini.

Additional information

Communicated by Antonio Secchi.

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Lucini, D., Zuccotti, G.V., Scaramuzza, A. et al. Exercise might improve cardiovascular autonomic regulation in adolescents with type 1 diabetes. Acta Diabetol 50, 341–349 (2013). https://doi.org/10.1007/s00592-012-0416-z

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  • DOI: https://doi.org/10.1007/s00592-012-0416-z

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