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Paed Diabetes – Improves lipid profile

Evidence Summary
High quality systematic reviews showed the beneficial effect of exercise on lipid profile. Quirk et al (1) looked at physical activity interventions in children and young people with Type 1 diabetes mellitus. The review looked at 10 randomised and 16 non-randomised studies. The results showed a benefit of physical activity on triglyceride level (five studies, 206 participants, standardized mean difference -0.70, 95% CI -1.25 to -0.14; P = 0.01). There was also a large effect size for total cholesterol (five studies, 206 participants, standardized mean difference -0.91, 95% CI -1.66 to -0.17; P = 0.02).
Aljawarneh et al. (2) looked at the effects of physical activity on physiological and biochemical outcomes in children and adolescents with Type 1 diabetes. The review looked at eight interventional and 19 observational studies. There were a total of 8,263 participants across all studies. A consistent agreement among the studies revealed a considerable benefit of regular habitual PA of light to moderate intensity on lipid profile.
A cross sectional analysis by Beraki et al. (3) demonstrated that physical activity prevents long term cardiovascular complications by improving lipid profile.
A multicentre study of 23,251 patients by Herbst et al. (4) showed that children with T1DM who were more physically active had lower lipoprotein levels.
There was however a systematic review by Angela et al. (5) which looked at 44 observational studies and showed an inverse association between physical fitness and lipid profile in adolescents with T1DM.

Quality of Evidence
Grade A as evidence is from multiple high quality studies
Strength of Recommendation
Grade 1 as multiple studies with similar conclusions


Conclusion
Physical activity interventions in children and young people with Type 1 diabetes mellitus improves lipid profile.


References
Quirk H, Blake H, Tennyson R et al. Physical activity interventions in children and young people with Type 1 diabetes mellitus: a systematic review with meta-analysis. Diabetes Med 2014;31(10):1163-73
Aljawarneh YM, Wardell DW, Wood GL et al A Systematic Review of Physical Activity and Exercise on Physiological and Biochemical Outcomes in Children and Adolescents With Type 1 Diabetes. Journal of Nursing Scholarship. 2019;51(3):337-345
Beraki, Å., Magnuson, A., Särnblad, S. et al Increase in physical activity is associated with lower HbA1c levels in children and adolescents with type 1 diabetes: Results from a cross-sectional study based on the Swedish pediatric diabetes quality registry (SWEDIABKIDS). Diabetes Research and Clinical Practice. (2014); 105(1):119-125.
Herbst A, Kordonouri O, Schwab KO, et al. Impact of physical activity on cardiovascular risk factors in children with type 1 diabetes: a multicenter study of 23,251 patients. Diabetes Care 2007;30(8):2098-100.
Angela DL, Ma X., David MM et al. Physical activity, sedentary behaviors, physical fitness, and their relation to health outcomes in youth with type 1 and type 2 diabetes: A review of the epidemiologic literature. J Sport Health Sci 2013;2(1)2:1–38

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