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Kids with Type 1 Diabetes Can Lower Heart Disease Risk with Exercise

With commentary by Alexia Pena Vargas, MD, PhD, researcher at the University of Adelaide's Robinson Research Institute and pediatric endocrinologist, Women's and Children's Hospital, Adelaide, and Joshua Tarkoff, MD, pediatric endocrinologist at Nicklaus Children's Hospital in Miami.

Children and teens with type 1 diabetes who move just a little more each day can help reduce their increased risk of heart disease, Australian researchers say.

type 1 and heart disease

"Children with type 1 diabetes are at higher risk of heart disease, but they can decrease this risk by increasing the number of steps they do every day," says study leader Alexia Pena Vargas, MD, PhD, a pediatric endocrinologist at the University of Adelaide and the Women's and Children's Hospital in Adelaide. 

Just 1,000 extra steps a day—about a half mile—improved heart disease risk factors, she found. Her team evaluated 90 boys and girls, average age 13 years old, with type 1 diabetes. They had been diagnosed for about five years on average.

The youth wore armbands that counted their steps for at least five consecutive days, including a weekend day. Most kept the counters on nearly round the clock. The researchers had information on the thickness of the aortic and carotid blood vessels. Thicker vessels reflect hardening of the arteries and a higher risk of cardiovascular disease.

When they looked at activity levels and the blood vessel thicknesses, they found that more activity lowered diabetes-related heart risks.

The study was published online June 15 in Diabetes Care.

Stepping Your Way To Better Health: Details

More than half of the youth, 48, took fewer than 10,000 steps a day (about five miles), the total often viewed as the ideal ''goal'' for physical activity. When the researchers compared physical activity and blood vessel thickness, they found that an increase in step count of just 1,000 a day was linked with a decrease in the thickness of aortic blood vessels (but not the carotid vessels). The link held even after the researchers took into account age, their AIC test, blood pressure and body weight.

Those who increased their step counts also had lower body weight, healthier blood pressure and healthier HDL ("good") cholesterol and triglyceride levels. The study shows ''the more steps you do the better for your heart," Dr. Vargas says.

Bottom line? "An extra 1,000 steps a day improves not only blood vessels but weight, blood pressure and [blood] lipids," Dr. Vargas says. Even the youth getting more than 10,000 steps daily had improvement with each extra 1,000, she says.

Those children with a daily step count lower than 10,000 had higher thickness in the aortic blood vessels than those with higher step counts, the researchers found. "An important clinical message is that even a small increase in activity relates to better vascular structure and risk factors," the researchers write.

The study was relatively small, and only a ''snapshot in time," the researchers say, yet the link they found was strong.

Kids & Exercise: Second Opinion

The new study findings add to a body of research that exercise, no matter how small the amount, is likely to have benefit, says Joshua Tarkoff, MD, pediatric endocrinologist at Nicklaus Children's Hospital in Miami. He reviewed the findings. The Australian researchers used thickness of the arteries as a surrogate for cardiovascular disease risk, which is standard, he says. "They are showing that being more active was related to weight loss, better HDL cholesterol and better blood pressure."

A good takeaway message for doctors and parents, he says, is that ''we are probably not doing a good enough job encouraging exercise."

Action Plan

In the U.S., about 1.25 million of the 29 million people with diabetes have type 1 diabetes, in which the body does not make enough insulin to move blood glucose into the cells. According to the U.S. Centers for Disease Control and Prevention (CDC), all children and teens should get in at least an hour of physical activity daily for health.

When Dr. Tarkoff discusses physical activity with his young patients, he focuses on the benefits. Getting more physical activity, he says, will probably make it easier to control blood sugar and they will need less insulin.

He also tells those with type 1 diabetes: "Do what works for you." It's crucial to pick something you will stick with, he says. "If that's going to the gym with an older brother," he says, fine. If watching You tube videos and dancing sounds good, he tells patients to go for it.

He also suggests taking a family walk, after dinner and homework are finished and reducing screen time in front of televisions and computers. "The killer is the sitting," he says.

 

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