Impact of Physical Activity on Cardiovascular Risk Factors in Children With Type 1 Diabetes

Type 1 diabetes is associated with a high risk for early atherosclerotic complications. Patients with type 1 diabetes have a fourfold (in men) to eightfold (in women) excess risk of coronary heart disease compared with that for the general population (1). It has been shown that type 1 diabetic patients aged 20–39 years have a fivefold higher risk of dying from cardio- and cerebrovascular events compared with that for healthy individuals (2). Development of atherosclerotic lesions in healthy subjects begins upon childhood. In children with type 1 diabetes who had died an unnatural death, an asymptomatic increase in the intima-media thickness of the common carotid artery was found (3). Known risk factors for vascular complications are long-standing diabetes, age, poor glycemic control, smoking, hypertension, obesity, and dyslipidemia (4–6). In a recent study, 69% of the pediatric patients with type 1 diabetes were found to have one or more cardiovascular risk factors (7). Thus, there is an urgent need for prevention strategies to reduce these risk factors in childhood and adolescence. We recently showed that frequency of regular physical activity (RPA) represents an important factor influencing glycohemoglobin and, in girls, BMI (8). The present study focuses on the impact of RPA on further cardiovascular risk factors such as plasma lipids and blood pressure in children with type 1 diabetes. Data were provided by the Pediatric Quality Initiative (9) and included anonymous longitudinal data of 23,251 patients (3–18 years) with type 1 diabetes from 209 centers in Germany and Austria. The data are continuously generated by the participating centers using the diabetes data acquisition system for prospective surveillance [DPV] software (Diabetes Software for Prospective Documentation) and after anonymization are transmitted to the Pediatric Quality Initiative for …