Lit Review of Exercise and Vascular Function in Diabetic Children

EXERCISE AND VASCULAR FUNCTION IN CHILDREN WITH TYPE I DM

This study is a quantitative study seeking to discover if regular exercise improves physical fitness and vascular function in children with type I diabetes mellitus. The authors expected that exercise training would improve endothelial function and decrease vascular wall thickness in the children being studied.

The authors' literature review included articles that ranged in dates of 1998-2011.

Since the article was published in 2011, the articles cited are recent for the time the study was published.

The study included nine between the ages of 8 and 12 who had a mean duration of DM1 of 2.7 ± 3.1 years. The participants were recruited from the Children Diabetes Centre Nijmegen, the Netherlands. Excluded from the study were children with DM2, cardiovascular pathology, mental retardation and contra-indications for physical exercise. The study was approved by the Ethics Committee of the Radboud University Nijmegen Medical Centre and adhered to the Declaration of Helsinki. All participants gave prior written consent.

The subjects participated in an 18 week exercise training program with running being the predominant exercise twice per week. Data was collected on two occasions - before and after the 18-week exercise program. The data collection process consisted of two separate visits. On the first visit, body characteristics including height, weight and waist circumference were measured, followed by a maximal running test. On the second visit, vascular measurements including brachial artery endothelial function and carotid artery wall thickness were performed. The data was statistically analyzed using SPSS 17.0 software, and the researchers compared the measurements taken at the beginning of the study to those at the end of the 18 week intervention.

The data was reported as mean ±standard deviation. Statistical significance was assumed at p < 0.05.

The researchers avoided bias in sampling by using custom designed, semi-automated edge-detection and wall-tracking software which is independent of investigator bias for post test analysis.

The main finding of this study is that 18-week exercise training, including two exercise sessions per week, effectively improves physical fitness and endothelial function in children with DM1. The improvement in brachial artery endothelial function after training in children with DM1 suggests that exercise training decreased the risk for future cardiovascular disease. However, exercise training did not alter carotid artery wall thickness in this short time period. The authors did note other studies that indicated otherwise with a longer duration of training.

Since impaired endothelial function is part of the atherosclerotic process and is predictive for future cardiovascular