ACTA
Acta Diabetol 29:11 - 13, 1992
DIABETOLOGICA 9 Springer-Verlag 1992
Exercise is not associated with better diabetes control in type 1 and type 2 diabetic subjects J.L. Selam 1, p. Casassus 2, E Bruzzo 1, C. Leroy 2, and G. Slama 1 1 Department of Diabetology, INSERM U341, H6tel-Dieu, Paris, France, and 2 INSERM U21, Villejuif, France
Abstract. In the clinical setting, the impact of educational efforts on the a m o u n t of regular exercise and its effects on diabetes control are unclear. Fifty type 1 diabetic, 50 type 2 diabetic and 70 non-diabetic subjects were evaluated using a questionnaire for type, duration and intensity of exercise to assess weekly energy expenditure. Diabetic subjects did not exercise more than controls: 36% of the type 1, 46% of the type 2 and 46% of the control subjects admitted no physical activity, and those exercising regularly had similar energy expenditure: 1808-t- 320, 2722 ___617, 2523 ___304 (mean__+ SEM) kcal/week respectively ( P = N S ) . There was no correlation between the degree of activity and HbAIr levels, or hypoglycaemic events. H b A l c levels were less than 6,8% in 31% of nonactive patients versus 21% of active patients (P = NS). A negative correlation was found between physical activity and daily insulin usage (r=0.27, P < 0 . 0 5 ) , but differences between patients averaged only 4 IU/1000 kcal energy expenditure/day. We conclude that patients' attitude towards exercise was not improved by our educational methods and that physical exercise was not necessarily associated with good blood glucose control.
However, in day-to-day clinical practice, the impact of exercise on long-term glycaemic control is not consistently evident [4-8]. This cross-sectional study was conducted to evaluate whether: (a) diabetic patients followed our advice and exercised m o r e than the average non-diabetic subjects, and (b) exercise was associated with better diabetes control and/or increased risk of hypoglycaemia.
Materials and methods Subjects Diabetic patients ( a total of 100; 50 with type 1 diabetes mellitus and 50 with type 2 non-insulin-dependent diabetes, i.e. treated with diet or oral hypoglycaemic drugs) from our regular diabetes clinics agreed to fill in a questionnaire. No other disease which might influence exercise habits, e.g. coronary heart disease, arthropathy or claudication was present in patients. As controls, 70 healthy non-diabetic subjects of similar socio-economic status (data not shown) were randomly chosen in the city. The clinical characteristics of subjects are shown in Table 1. The only statistically significant differences between the groups were for age and BMI, both of which were higher in type 2 patients, and for duration of diabetes, which was longer in the type 1 patients.
Key words: Exercise - Diabetes control - type 1 diabetes mellitus - type 2 diabetes mellitus Table 1. Patients' characteristics n
Introduction Regular physical exercise has long been recommended as an important c o m p o n e n t of the m a n a g e m e n t of both type 1 and type 2 diabetes mellitus [1-3]. Effects on diabetic patients include a decrease in blood glucose levels, improved insulin sensitivity, decrease in insulin requirements and a higher risk of hypoglycaemia [3]. Regular physical exercise is therefore part of the diabetic educational p r o g r a m m e of our centre and of most centres.
Correspondence to: G. Slama, Service de Diabrtologie, 1, place du Parvis de Notre-Dame, F-75004 Paris, France
Type1 50 patients Type2 50 patients Control 70 subjects
Age (years)
Sex BMI (%male)
Duration HbAlc of diabetes % (years)
41_+11
50
24+2
16+_8
55_+10
54
27_+5 10___9
8.0_+2.0
43_+14
54
23+3
NA
NA
8.1+1.1
Differences between type 2 patients vs controls or type I patients are significant for age and BMI (P
Acta Diabetol 29:11 - 13, 1992
DIABETOLOGICA 9 Springer-Verlag 1992
Exercise is not associated with better diabetes control in type 1 and type 2 diabetic subjects J.L. Selam 1, p. Casassus 2, E Bruzzo 1, C. Leroy 2, and G. Slama 1 1 Department of Diabetology, INSERM U341, H6tel-Dieu, Paris, France, and 2 INSERM U21, Villejuif, France
Abstract. In the clinical setting, the impact of educational efforts on the a m o u n t of regular exercise and its effects on diabetes control are unclear. Fifty type 1 diabetic, 50 type 2 diabetic and 70 non-diabetic subjects were evaluated using a questionnaire for type, duration and intensity of exercise to assess weekly energy expenditure. Diabetic subjects did not exercise more than controls: 36% of the type 1, 46% of the type 2 and 46% of the control subjects admitted no physical activity, and those exercising regularly had similar energy expenditure: 1808-t- 320, 2722 ___617, 2523 ___304 (mean__+ SEM) kcal/week respectively ( P = N S ) . There was no correlation between the degree of activity and HbAIr levels, or hypoglycaemic events. H b A l c levels were less than 6,8% in 31% of nonactive patients versus 21% of active patients (P = NS). A negative correlation was found between physical activity and daily insulin usage (r=0.27, P < 0 . 0 5 ) , but differences between patients averaged only 4 IU/1000 kcal energy expenditure/day. We conclude that patients' attitude towards exercise was not improved by our educational methods and that physical exercise was not necessarily associated with good blood glucose control.
However, in day-to-day clinical practice, the impact of exercise on long-term glycaemic control is not consistently evident [4-8]. This cross-sectional study was conducted to evaluate whether: (a) diabetic patients followed our advice and exercised m o r e than the average non-diabetic subjects, and (b) exercise was associated with better diabetes control and/or increased risk of hypoglycaemia.
Materials and methods Subjects Diabetic patients ( a total of 100; 50 with type 1 diabetes mellitus and 50 with type 2 non-insulin-dependent diabetes, i.e. treated with diet or oral hypoglycaemic drugs) from our regular diabetes clinics agreed to fill in a questionnaire. No other disease which might influence exercise habits, e.g. coronary heart disease, arthropathy or claudication was present in patients. As controls, 70 healthy non-diabetic subjects of similar socio-economic status (data not shown) were randomly chosen in the city. The clinical characteristics of subjects are shown in Table 1. The only statistically significant differences between the groups were for age and BMI, both of which were higher in type 2 patients, and for duration of diabetes, which was longer in the type 1 patients.
Key words: Exercise - Diabetes control - type 1 diabetes mellitus - type 2 diabetes mellitus Table 1. Patients' characteristics n
Introduction Regular physical exercise has long been recommended as an important c o m p o n e n t of the m a n a g e m e n t of both type 1 and type 2 diabetes mellitus [1-3]. Effects on diabetic patients include a decrease in blood glucose levels, improved insulin sensitivity, decrease in insulin requirements and a higher risk of hypoglycaemia [3]. Regular physical exercise is therefore part of the diabetic educational p r o g r a m m e of our centre and of most centres.
Correspondence to: G. Slama, Service de Diabrtologie, 1, place du Parvis de Notre-Dame, F-75004 Paris, France
Type1 50 patients Type2 50 patients Control 70 subjects
Age (years)
Sex BMI (%male)
Duration HbAlc of diabetes % (years)
41_+11
50
24+2
16+_8
55_+10
54
27_+5 10___9
8.0_+2.0
43_+14
54
23+3
NA
NA
8.1+1.1
Differences between type 2 patients vs controls or type I patients are significant for age and BMI (P
