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March 1985, Vol 139, No. 3 >
Article | March 1985

Glycemic Control With Physical Training in Insulin-Dependent Diabetes Mellitus FREE

Thomas W. Rowland, MD; Laurie A. Swadba, MEd; Darlene E. Biggs, RN, MS; Edmund J. Burke, PhD; Edward O. Reiter, MD
[+] Author Affiliations

Reprint requests to Department of Pediatrics, Baystate Medical Center, 759 Chestnut St, Springfield, MA 01107 (Dr Rowland).


Am J Dis Child. 1985;139(3):307-310. doi:10.1001/archpedi.1985.02140050101035.
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Physical exercise has long been a cornerstone in the management of diabetes mellitus based on its potential to improve metabolic control and to diminish risk factors for atherosclerotic vascular disease common in older diabetic persons.1-3 Participation in physical activity may also have psychosocial benefits in improving selfesteem and feelings of well-being, which are especially important in patients with chronic disease.4

Efforts to document the physiologic responses to exercise in patients with diabetes mellitus have only recently been successful. The recognition that serum glycosylated hemoglobin (HbA1) levels provide a valid marker of metabolic control5,6 and the use of euglycemic clamp techniques in determination of insulin sensitivity7 have allowed new insights into the diabetesexercise relationship. These studies have indicated differences in type 1 (insulin-dependent) and type 2 (adultonset) diabetic patients and have also separated alterations in metabolic status created by short-term exercise from those resulting from physical

REFERENCES

1 +
Joslin EP:  The treatment of diabetes mellitus , in Joslin EP, Root HF, White P, et al (eds): The Treatment of Diabetes Mellitus , ed 10. Philadelphia, Lea & Febiger, 1959;, pp 243-300.
2 +
Richter EA, Ruderman NB, Schneider SH:  Diabetes and exercise . Am J Med 1981;;70: 201-209.
Link to Article
3 +
Vranic M, Berger M:  Exercise and diabetes mellitus . Diabetes 1979;;28:147-163.
4 +
Riley WJ, Rosenbloom AL:  Exercise and insulin dependent diabetes mellitus . J Fla Med Assoc 1980;;67:392-394.
5 +
Gabbay KH, Hasty K, Breslow JL, et al:  Glycosylated hemoglobins and long-term blood glucose control in diabetes mellitus . J Clin Endocrinol Metabol 1977;;44:859-864.
Link to Article
6 +
Jovanovic L, Peterson CM:  The clinical utility of glycosylated hemoglobin . Am J Med 1981;;70:331-338.
Link to Article
7 +
DeFronzo RA, Tobin JD, Andres R:  Glucose clamp technique: A method for quantifying insulin secretion and resistance . Am J Physiol 1979;;237:214-223.
8 +
Campaigne BN, Gilliam TB, Spencer ML, et al:  The effects of a physical activity program on children with insulin dependent diabetes mellitus . Med Sci Sports Exerc 1983;;15:149.
9 +
Wallberg-Henriksson H, Gunnarsson R, Henriksson J, et al:  Increased peripheral insulin sensitivity and muscle mitochondrial enzymes but unchanged blood glucose control in type I diabetics after physical training . Diabetes 1982;; 31:1044-1050.
Link to Article
10 +
Kirk RE: Experimental Design: Procedures for the Behavioral Sciences . Belmont, Calif, Brooks/Cole Publishing Co, 1968;, p 146.
11 +
Soman V, Koivisto V, Grantham P, et al:  Increased insulin binding to monocytes after acute exercise in normal man . J Clin Endocrinol Metabol 1978;;47:216-219.
Link to Article
12 +
Galbo H, Christensen NJ, Holst JJ:  Catecholamines and pancreatic hormones during autonomic blockade in exercising man . Acta Physiol Scand 1977;;101:428-434.
Link to Article
13 +
Pederson O, Beck-Nielsen H, Heding L:  Increased insulin receptors after exercise in patients with insulin dependent diabetes mellitus . N Engl J Med 1980;;302:886-892.
Link to Article
14 +
Lohmann D, Liebold F, Heilman W, et al:  Diminished insulin response in highly trained athletes . Metabolism 1978;;27:521-524.
Link to Article
15 +
Rosenthal M, Haskell WL, Solomon R, et al:  Demonstration of a relationship between level of physical training and insulin-stimulated glucose utilization in normal humans . Diabetes 1983;;32:408-411.
Link to Article
16 +
Koivisto VA, Soman V, Conrad P, et al:  Insulin binding to monocytes in trained athletes: Changes in the resting state and after exercise . J Clin Invest 1979;;64:1011-1015.
Link to Article
17 +
Saltin B, Lindgarde F, Houston M, et al:  Physical training and glucose tolerance in middle-aged men with chemical diabetes . Diabetes 1979;;28( (suppl 1) ):30-32.
18 +
Ruderman NB, Ganda OP, Johansen K:  The effect of physical training on glucose tolerance and plasma lipids in maturity onset diabetes . Diabetes 1979;;28( (suppl 1) ):89-92.
19 +
Larsson YA, Sterky GC, Ekengren KE, et al:  Physical fitness and the influence of training in diabetic adolescent girls . Diabetes 1962;;11: 109-117.
20 +
Engerbretson DL:  The effects of exercise upon diabetic control . J Assoc Phys Ment Rehabil 1965;;19:74-78.
21 +
Ludvigsson J:  Physical exercise in relation to degree of metabolic control in juvenile diabetics . Acta Paediatr Scand Suppl 1980;;283: 45-49.
Link to Article
22 +
Koivisto VA, Groop L:  Physical training in juvenile diabetes . Ann Clin Res 1982;;14( (suppl 34) ):74-79.
23 +
Dahl-Jorgensen K, Meen HD, Hanssen KF, et al:  The effect of exercise on diabetic control and hemoglobin A1 (HbA1) in children . Acta Paediatr Scand Suppl 1980;;283:53.
Link to Article
24 +
Huisman TJ, Horton BF:  Studies on the heterogeneity of hemoglobin VIII: Chromatographic and electrophoretic investigations of various minor hemoglobin fractions present in normal and in vitro modified red blood cell hemolysates . J Chromatogr 1965;;18:116-123.
Link to Article
25 +
Peterson CM, Jones RL, Esterly JA, et al:  Changes in basement membrane thickening and pulse volume concomitant with improved glucose control and exercise in patients with insulindependent diabetes mellitus . Diabetes Care 1980;;3:586-589.
Link to Article
26 +
Zawalich W, Maturo S, Felig P:  Physical training: Decreased insulin secretion and liver glucokinase in the rat , abstracted. Clin Res 1981;;29:683.
27 +
Sterky G:  Physical work capacity in diabetic school children . Acta Paediatr 1963;;52:1-10.
Link to Article
28 +
Rubler S, Arvan S:  Exercise testing in young asymptomatic diabetic patients . Angiology 1976;;27:548-552.
Link to Article
29 +
Cooper DM, Weiler-Ravell D, Wasserman K: Is oxygen availability impaired during exercise in children with diabetes? Read before the Research Symposium on Diabetes and Exercise, Burlington, Vt, July 27, 1983.
30 +
Friedman NE, Levitsky LL, Edidin DV:  Echocardiographic evidence for impaired myocardial performance in children with type I diabetes mellitus . Am J Med 1982;;73:846-850.
Link to Article
31 +
Pate RR, Blair SN:  Exercise and the prevention of atherosclerosis: Pediatric implications , in Strong WB (ed): Atherosclerosis: Its Pediatric Aspects . New York, Grune & Stratton Inc, 1978;, chap 13.
32 +
Ekblom G:  Effect of physical training in adolescent boys . J Appl Physiol 1969;;27:350-357.
33 +
Rowland TW:  Physical fitness in children: Implications for the prevention of coronary artery disease . Curr Probl Pediatr 1981;;11:1-54.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

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References

1 +
Joslin EP:  The treatment of diabetes mellitus , in Joslin EP, Root HF, White P, et al (eds): The Treatment of Diabetes Mellitus , ed 10. Philadelphia, Lea & Febiger, 1959;, pp 243-300.
2 +
Richter EA, Ruderman NB, Schneider SH:  Diabetes and exercise . Am J Med 1981;;70: 201-209.
Link to Article
3 +
Vranic M, Berger M:  Exercise and diabetes mellitus . Diabetes 1979;;28:147-163.
4 +
Riley WJ, Rosenbloom AL:  Exercise and insulin dependent diabetes mellitus . J Fla Med Assoc 1980;;67:392-394.
5 +
Gabbay KH, Hasty K, Breslow JL, et al:  Glycosylated hemoglobins and long-term blood glucose control in diabetes mellitus . J Clin Endocrinol Metabol 1977;;44:859-864.
Link to Article
6 +
Jovanovic L, Peterson CM:  The clinical utility of glycosylated hemoglobin . Am J Med 1981;;70:331-338.
Link to Article
7 +
DeFronzo RA, Tobin JD, Andres R:  Glucose clamp technique: A method for quantifying insulin secretion and resistance . Am J Physiol 1979;;237:214-223.
8 +
Campaigne BN, Gilliam TB, Spencer ML, et al:  The effects of a physical activity program on children with insulin dependent diabetes mellitus . Med Sci Sports Exerc 1983;;15:149.
9 +
Wallberg-Henriksson H, Gunnarsson R, Henriksson J, et al:  Increased peripheral insulin sensitivity and muscle mitochondrial enzymes but unchanged blood glucose control in type I diabetics after physical training . Diabetes 1982;; 31:1044-1050.
Link to Article
10 +
Kirk RE: Experimental Design: Procedures for the Behavioral Sciences . Belmont, Calif, Brooks/Cole Publishing Co, 1968;, p 146.
11 +
Soman V, Koivisto V, Grantham P, et al:  Increased insulin binding to monocytes after acute exercise in normal man . J Clin Endocrinol Metabol 1978;;47:216-219.
Link to Article
12 +
Galbo H, Christensen NJ, Holst JJ:  Catecholamines and pancreatic hormones during autonomic blockade in exercising man . Acta Physiol Scand 1977;;101:428-434.
Link to Article
13 +
Pederson O, Beck-Nielsen H, Heding L:  Increased insulin receptors after exercise in patients with insulin dependent diabetes mellitus . N Engl J Med 1980;;302:886-892.
Link to Article
14 +
Lohmann D, Liebold F, Heilman W, et al:  Diminished insulin response in highly trained athletes . Metabolism 1978;;27:521-524.
Link to Article
15 +
Rosenthal M, Haskell WL, Solomon R, et al:  Demonstration of a relationship between level of physical training and insulin-stimulated glucose utilization in normal humans . Diabetes 1983;;32:408-411.
Link to Article
16 +
Koivisto VA, Soman V, Conrad P, et al:  Insulin binding to monocytes in trained athletes: Changes in the resting state and after exercise . J Clin Invest 1979;;64:1011-1015.
Link to Article
17 +
Saltin B, Lindgarde F, Houston M, et al:  Physical training and glucose tolerance in middle-aged men with chemical diabetes . Diabetes 1979;;28( (suppl 1) ):30-32.
18 +
Ruderman NB, Ganda OP, Johansen K:  The effect of physical training on glucose tolerance and plasma lipids in maturity onset diabetes . Diabetes 1979;;28( (suppl 1) ):89-92.
19 +
Larsson YA, Sterky GC, Ekengren KE, et al:  Physical fitness and the influence of training in diabetic adolescent girls . Diabetes 1962;;11: 109-117.
20 +
Engerbretson DL:  The effects of exercise upon diabetic control . J Assoc Phys Ment Rehabil 1965;;19:74-78.
21 +
Ludvigsson J:  Physical exercise in relation to degree of metabolic control in juvenile diabetics . Acta Paediatr Scand Suppl 1980;;283: 45-49.
Link to Article
22 +
Koivisto VA, Groop L:  Physical training in juvenile diabetes . Ann Clin Res 1982;;14( (suppl 34) ):74-79.
23 +
Dahl-Jorgensen K, Meen HD, Hanssen KF, et al:  The effect of exercise on diabetic control and hemoglobin A1 (HbA1) in children . Acta Paediatr Scand Suppl 1980;;283:53.
Link to Article
24 +
Huisman TJ, Horton BF:  Studies on the heterogeneity of hemoglobin VIII: Chromatographic and electrophoretic investigations of various minor hemoglobin fractions present in normal and in vitro modified red blood cell hemolysates . J Chromatogr 1965;;18:116-123.
Link to Article
25 +
Peterson CM, Jones RL, Esterly JA, et al:  Changes in basement membrane thickening and pulse volume concomitant with improved glucose control and exercise in patients with insulindependent diabetes mellitus . Diabetes Care 1980;;3:586-589.
Link to Article
26 +
Zawalich W, Maturo S, Felig P:  Physical training: Decreased insulin secretion and liver glucokinase in the rat , abstracted. Clin Res 1981;;29:683.
27 +
Sterky G:  Physical work capacity in diabetic school children . Acta Paediatr 1963;;52:1-10.
Link to Article
28 +
Rubler S, Arvan S:  Exercise testing in young asymptomatic diabetic patients . Angiology 1976;;27:548-552.
Link to Article
29 +
Cooper DM, Weiler-Ravell D, Wasserman K: Is oxygen availability impaired during exercise in children with diabetes? Read before the Research Symposium on Diabetes and Exercise, Burlington, Vt, July 27, 1983.
30 +
Friedman NE, Levitsky LL, Edidin DV:  Echocardiographic evidence for impaired myocardial performance in children with type I diabetes mellitus . Am J Med 1982;;73:846-850.
Link to Article
31 +
Pate RR, Blair SN:  Exercise and the prevention of atherosclerosis: Pediatric implications , in Strong WB (ed): Atherosclerosis: Its Pediatric Aspects . New York, Grune & Stratton Inc, 1978;, chap 13.
32 +
Ekblom G:  Effect of physical training in adolescent boys . J Appl Physiol 1969;;27:350-357.
33 +
Rowland TW:  Physical fitness in children: Implications for the prevention of coronary artery disease . Curr Probl Pediatr 1981;;11:1-54.

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