Impact of physical activity on cardiovascular risk factors in children with type 1 diabetes: a multicenter study of 23,251 patients.

T ype 1 diabetes is associated with a high risk for early atherosclerotic complications. Patients with type 1 diabetes have a fourfold (in men) to eightfold (in women) excess risk of coronary heart disease compared with that for the general population (1). It has been shown that type 1 diabetic patients aged 20–39 years have a fivefold higher risk of dying from cardioand cerebrovascular events compared with that for healthy individuals (2). Development of atherosclerotic lesions in healthy subjects begins upon childhood. In children with type 1 diabetes who had died an unnatural death, an asymptomatic increase in the intimamedia thickness of the common carotid artery was found (3). Known risk factors for vascular complications are longstanding diabetes, age, poor glycemic control, smoking, hypertension, obesity, and dyslipidemia (4 – 6). In a recent study, 69% of the pediatric patients with type 1 diabetes were found to have one or more cardiovascular risk factors (7). Thus, there is an urgent need for prevention strategies to reduce these risk factors in childhood and adolescence. We recently showed that frequency of regular physical activity (RPA) represents an important factor influencing glycohemoglobin and, in girls, BMI (8). The present study focuses on the impact of RPA on further cardiovascular risk factors such as plasma lipids and blood pressure in children with type 1 diabetes.