Is It Really True?

Children that suffer from the chronic illness of type 1 diabetes mellitus have a diminished bone marrow density because of insulin deficiency.  Maggio et al. (2011) note that their research attempts to look at the dose and type of exercise needed for a child with type 1 diabetes mellitus (T1DM)  that will optimize bone mineral acquisition because research in this area is still not well defined. Thus, the main aim of their study determines what the effects of weight-bearing physical activity on bone mineral mass and bone turnover markers in young children with type 1 diabetes mellitus in comparison to those of healthy children.

Twenty-seven chidren who were diabetic were recruited from the Unit of Pediatric Endocrinology and Diabetology of the University Hospitals of Geneva between  the ages of 8-12. Thirty-two healthy children, also between the ages of 8-12 were recruited as peers of the diabetic children or from local schools. Both the diabetic and healthy candidates for this study were excluded for the following reasons: presence of other chronic disease, medications, hormones other than insulin or calcium preparations, presence of nephropathy, systematic disease or hospitlization for more than 2 weeks in the preceding year, and participation in competition sport (Maggio et al., 2011).

Participants with T1DM and healthy participants were randomized by gender to groups: the exercise diabetic group and the exercise healthy group (experimental groups) and the control  diabetic group and the control healthy group. Maggio et al. (2011) note that this randomization process resulted  in a similar girls/boys ratio within each group.  Children (healthy and diabetic) who were in the exercise group were instructed to go to two 90-minute exercise sessions per week for the period of 9 months. Maggio et al. (2011) demonstrate that the exercise sessions were supervised by two physical education teachers as well as, a pediatrician with experience in T1DM. Participants took part in various weight-bearing activities such as jump rope, jumping, and gymnastics. Maggio et al. (2011) also increased intensity and difficulty levels as the months progressed. The researchers (2011) also accounted for  physical leisure activity for the past 12 months via questionnaire.

All the young children that participated were tested at baseline, prior to the study, and after the 9 months had elasped during the same period (Maggio et al., 2011).  This was done to reduce some extraneous variables such as leisure time for physical activity and vitamin D concentrations. Body weight, height, body mass index (BMI), pubertal development, and lead body mass were all measured. Maggio et al. (2011) also, assessed areal bone mineral density (aBMD), lumbar spine, right femoral nech and greater trochanter.

As for the main results, researchers (2011) found that T1DM children that were in the exercise group (180 minutes of weight bearing activity/week) had improved their total body and lumbar spine bone mineral densities compared to those  diabetic patients within the control group.  What Maggio et al. (2011) find interesting is that total body and lumbar spine bone mineral densities were improved in healthy children as much as they were in participants with T1DM. Researchers (2011) also found that physical activity has different influences on different bone sites in regards to gender and pubertal stages. There are factors such as type of exercise, training duration and volume that physical activity is dependent on, as well.

What is limiting in Maggio et al. (2011) study is that their sample size was relatively small, therefore, generalizations towards the public in regards to the findings can not be made with complete assurance. Researchers (2011) further note that due to the small sample size,  a sub-analysis cannot be conducted to evaluate other factors (age and puberty) on the different variables.

This study is, however, interesting because of the quality of the researcher’s (2011) study design and the fact that there were no drop outs from the study. Also, researchers (2011) looked at something that still needed defining, which will yield an additional amount of research conducted in this area.

These findings suggest that there are positive effects of weight-bearing physical activity on total body and lumbar spine bone mineral aquistion with T1DM.Therefore, the take home message of this study conducted by Maggio et al. (2011) is that weight-bearing sports (ball games, jumping activities, gymnastics) should be encouraged and become prevalent in children with Type 1 Diabetes Mellitus in so that bone mineral acquisition is optimized during growth. Maggio et al. (2011) also make note that physical activity within these diabetic patients will prevent the development of osteoporosis later in life.

References  

Maggio, Albane B., Laetitia M. Marchand, Serge Ferrari, René Rizzoli, Maurice Beghetti, and Nathalie J. Farpour-Lambert. "Physical Activity Increases Bone Mineral Density In Children With Type 1 Diabetes: A Randomized Controlled Trial." Medicine & Science in Sports & Exercise 41.Supplement 1 (2011). PubMed. Web. 17 Mar. 2012.