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Minuto N.,Centro Regionale Diabetologia Pediatrica | Arrighi A.,University of Genoa | Marchi M.,Centro Regionale Diabetologia Pediatrica | Diana P.,Centro Regionale Diabetologia Pediatrica | And 8 more authors.
Giornale Italiano di Diabetologia e Metabolismo | Year: 2012

Glycemic variability assessment is now considered a key tool in the evaluation of treatment and prognosis in type 1 diabetes mellitus (DM1). The risk of developing micro- and macrovascular long-term complications is driven more by glucose oscillations than glycated hemoglobin (HbA1c). A high blood glucose index (HBGI) and a low blood glucose index (LBGI) serve to define each patient's risk of hyper- and hypoglycemia respectively. Physical activity plays a major role in the management of DM1 patients. Exercise enhances insulin sensitivity, lowering the insulin requirement, and improves the lipid profile, reducing cardiovascular risk and helping patients to lose weight. We therefore investigated whether increased everyday physical activity in a supervised, dedicated environment could change the risk classes in DM1 patients. We examined 14 children (M:F 1.33, age 8-12 years) in a special summer camp for DM1 patients. The Accu-Chek® Aviva Nano glucometer was employed to measure daily glucose values and the Accu-Chek® Smart Pix software was then used to calculate the median, standard deviations, HBGI and LBGI. For each patient, measurements acquired at the summer camp were compared to those recorded at home the week before, in order to correlate changes in classes of risk with the daily exercise. We employed Fisher's test to analyze differences between groups. There was a significant reduction in LBGI (p < 0.023) during the camp compared to the previous period of normal daily activity. Absolute glucose measurements and the week's SD tended to improve, though without reaching statistical significance. In these summer camps dedicated to DM1 patients, children learn to manage their insulin requirements and adjust the daily doses in relation to physical exercise, through carefully checking blood glucose. Source

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