Clinical Outcomes to Exercise Training in Type 1 Diabetes: A Systematic Review and Meta-Analysis.

AIMS: To establish the relationship between exercise training and clinical outcomes in people with type I diabetes. METHODS: Studies were identified through a MEDLINE search strategy, Cochrane Controlled Trials Registry, CINAHL, SPORTDiscus and Science Citation Index. The search strategy included a mix of key concepts related to exercise training; type 1 diabetes; glycaemic control for trials of exercise training in people with type 1 diabetes. Searches were limited to prospective randomized or controlled trials of exercise training in humans with type 1 diabetes lasting 12 weeks or more. RESULTS: In exercised adults there were significant improvements in body mass Mean Difference (MD): -2.20 kg, 95% Confidence Interval (CI) -3.79 -0.61, p=0.007; body mass index (BMI) MD: -0.39 kg/m2, 95% CI -0.75 -0.02, p=0.04; Peak VO2MD: 4.08 ml/kg/min, 95% CI 2.18 5.98, p<0.0001; and, low-density lipoprotein cholesterol (LDL) MD: -0.21 mmol/L, 95% CI -0.33 -0.08, p=0.002. In exercised children there were significant improvements in insulin dose MD: -0.23 IU/kg, 95% CI -0.37 -0.09, p=0.002; waist circumference MD: -5.40 cm, 95% CI -8.45 -2.35, p=0.0005; LDL MD: -0.31 mmol/L, 95% CI -0.55 -0.06, p=0.02; and, triglycerides MD: -0.21 mmol/L, 95% CI -0.42 -0.0, p=0.04. There were no significant changes in glycosylated haemoglobin (HbA1C%), fasting blood glucose, resting heart rate, resting systolic blood pressure or high density lipoproteins in either group. CONCLUSIONS: Exercise training improves some markers of type 1 diabetes severity; particularly body mass, BMI, Peak VO2and LDL in adults and insulin dose, waist circumference, LDL and triglycerides in children.