Quirk H, Blake H, Tennyson R, Randell T L, Glazebrook C
School of Health Sciences, University of Nottingham.
Diabet Med. 2014 Oct;31(10):1163-73. doi: 10.1111/dme.12531.
To synthesize evidence from randomized and non-randomized studies of physical activity interventions in children and young people with Type 1 diabetes so as to explore clinically relevant health outcomes and inform the promotion of physical activity.
We conducted a search of CINAHL Plus, the Cochrane Library, EMBASE, MEDLINE, PsycINFO, SCOPUS, SportDiscus and Web of Science between October and December 2012. Eligible articles included subjects aged ≤18 years with Type 1 diabetes and a physical activity intervention that was more than a one-off activity session. Physiological, psychological, behavioural or social outcomes were those of interest.
A total of 26 articles (10 randomized and 16 non-randomized studies), published in the period 1964-2012, were reviewed. Although there was heterogeneity in study design, methods and reporting, 23 articles reported at least one significant beneficial health outcome at follow-up. Meta-analyses of these studies showed potential benefits of physical activity on HbA1c (11 studies, 345 participants, standardized mean difference -0.52, 95% CI -0.97 to -0.07; P = 0.02), BMI (four studies, 195 participants, standardized mean difference -0.41, 95% CI -0.70 to -0.12; P = 0.006) and triglycerides (five studies, 206 participants, standardized mean difference -0.70, 95% CI -1.25 to -0.14; P = 0.01).The largest effect size was for total cholesterol (five studies, 206 participants, standardized mean difference -0.91, 95% CI -1.66 to -0.17; P = 0.02).
Physical activity is important for diabetes management and has the potential to delay cardiovascular disease, but there is a lack of studies that are underpinned by psychological behaviour change theory, promoting sustained physical activity and exploring psychological outcomes. There remains a lack of knowledge of how to promote physical activity in people with Type 1 diabetes.
综合针对1型糖尿病儿童和青少年进行体育活动干预的随机和非随机研究证据，以探索临床相关的健康结局，并为促进体育活动提供信息。
我们于2012年10月至12月期间检索了CINAHL Plus、Cochrane图书馆、EMBASE、MEDLINE、PsycINFO、SCOPUS、SportDiscus和科学网。符合条件的文章包括年龄≤18岁的1型糖尿病患者以及超过一次性活动课程的体育活动干预。生理、心理、行为或社会结局是我们感兴趣的内容。
共回顾了1964年至2012年期间发表的26篇文章（10项随机研究和16项非随机研究）。尽管研究设计、方法和报告存在异质性，但23篇文章报告了随访时至少一项显著有益的健康结局。对这些研究的荟萃分析表明，体育活动对糖化血红蛋白（11项研究，345名参与者，标准化均数差-0.52，95%可信区间-0.97至-0.07；P=0.02）、体重指数（4项研究，195名参与者，标准化均数差-0.41，95%可信区间-0.70至-0.12；P=0.006）和甘油三酯（5项研究，206名参与者，标准化均数差-0.70，95%可信区间-1.25至-0.14；P=0.01）有潜在益处。效应量最大的是总胆固醇（5项研究,206名参与者，标准化均数差-0.91，95%可信区间-1.66至-0.17；P=0.02）。
体育活动对糖尿病管理很重要，并且有可能延缓心血管疾病，但缺乏以心理行为改变理论为基础、促进持续体育活动并探索心理结局的研究。对于如何促进1型糖尿病患者的体育活动仍然缺乏了解。
