Shorey Shefaly, Ng Esperanza D, Law Evelyn C, Wong John C M, Loke Kah Yin, Tam Wilson W S
Alice Lee Center for Nursing Studies.
National University Health System, Singapore.
Pediatrics. 2022 Sep 1;150(3). doi: 10.1542/peds.2022-056540.
Current evidence is lacking on physical activity and nutrition-based interventions focusing on the management of type 1 diabetes mellitus (T1DM) and health-related quality of life among children. To assess the effects of physical activity interventions and nutrition-based interventions for children with T1DM.
Data sources include the Cochrane Central Register of Controlled Trials, Medline, clinicaltrials.gov, the World Health Organization International Clinical Trials Registry Platform, CINAHL through January 2022. Study selection includes randomized controlled trials of children aged 18 years and below with T1DM comparing either a physical activity intervention, a nutrition-based intervention, or hybrid physical activity and nutrition-based intervention with placebo or no-treatment control. Data were pooled using a random-effects model. Primary outcomes were hemoglobin A1c (HbA1c), and health-related quality of life.
Eighteen trials were included. Physical activity compared with the no-treatment group showed a lack of effect on HbA1c (mean difference = -0.58, 95% confidence interval -1.20 to 0.05; P value = .07). Nutrition-based intervention compared with no-treatment control for HbA1c level revealed a lack of effect (mean difference = -0.61, 95% confidence interval -1.48 to 0.26; P value = .17). Limitations include paucity of studies and low quality of evidence caused by the risk of bias.
Despite the lack of significant evidence, the generally favorable results highlight the potential of such interventions in enhancing glycemic control and health-related quality of life. Additionally, promising results from a single physical activity-nutrition-based hybrid intervention in terms of glycemic control indicate the plausible effectiveness of a mixed intervention.
目前缺乏针对1型糖尿病（T1DM）患儿管理及健康相关生活质量的体育活动和营养干预方面的证据。旨在评估体育活动干预和营养干预对T1DM患儿的影响。
数据来源包括截至2022年1月的Cochrane对照试验中央登记库、Medline、clinicaltrials.gov、世界卫生组织国际临床试验注册平台、CINAHL。研究选择包括对18岁及以下T1DM患儿进行的随机对照试验，比较体育活动干预、营养干预或体育活动与营养混合干预与安慰剂或无治疗对照。数据采用随机效应模型进行汇总。主要结局指标为糖化血红蛋白（HbA1c）和健康相关生活质量。
纳入18项试验。体育活动组与无治疗组相比，对HbA1c无显著影响（平均差值=-0.58，95%置信区间-1.20至0.05；P值=0.07）。营养干预组与无治疗对照组相比，对HbA1c水平无显著影响（平均差值=-0.61，95%置信区间-1.48至0.26；P值=0.17）。局限性包括研究数量少以及偏倚风险导致的证据质量低。
尽管缺乏显著证据，但总体上有利的结果凸显了此类干预在改善血糖控制和健康相关生活质量方面的潜力。此外，一项基于体育活动与营养的混合干预在血糖控制方面的良好结果表明了混合干预可能有效。
