Impact of regular physical activity on blood glucose control and cardiovascular risk factors in adolescents with type 2 diabetes mellitus – a multicenter study of 578 patients from 225 centres

Regular physical activity ( RPA ) is a major therapeutic recommendation in children and adolescents with type 2 diabetes mellitus ( T2DM ). We evaluated the association between frequency of RPA and metabolic control, cardiovascular risk factors, and treatment regimes. Methods The Pediatric Quality Initiative ( DPV ), including data from 225 centers in Germany and Austria, provided anonymous data of 578 patients (10–20 yr; mean 15.7 ± 2.1 yr; 61.9% girls) with T2DM . Patients were grouped by the frequency of their self‐reported RPA per week: RPA 0 , none; RPA 1 , 1–2×/wk; RPA 2 , >2×/wk. Results The frequency of RPA ranged from 0 to 9×/wk (mean 1.1×/wk ±1.5). 55.7% of the patients reported no RPA (58.1% of the girls). Hemoglobin A1c ( HbA1c ) differed significantly among RPA groups (p < 0.002), being approximately 0.8 percentage points lower in RPA 2 compared to RPA 0 . Body mass index ( BMI‐SDS ) was higher in the groups with less frequent RPA (p < 0.00001). Multiple regression analysis revealed a negative association between RPA and HbA1c (p < 0.0001) and between RPA and BMI‐SDS (p < 0.01). The association between RPA and high density lipoprotein ( HDL )‐cholesterol was positive (p < 0.05), while there was no association to total cholesterol, low density lipoprotein ( LDL )‐cholesterol or triglycerides. Approximately 80% of the patients received pharmacological treatment (oral antidiabetic drugs and/or insulin) without differences between RPA groups. Conclusion More than half of the adolescents with T2DM did not perform RPA . Increasing physical activity was associated with a lower HbA1c , a lower BMI‐SDS , a higher HDL ‐cholesterol, but not with a difference in treatment regime. These results suggest that regular exercise is a justified therapeutic recommendation for children and adolescents with T2DM .