ISSN: 1301-2193 E-ISSN: 1308-9846
  • Turkish Journal of
    Endocrinology and Metabolism
ORIGINAL ARTICLE

Physical Activity, Insulin Sensitivity, and Metabolic Control in Type 1 Diabetes Mellitus
Tip 1 Diabetes Mellitusta Fiziksel Aktivite, İnsülin Duyarlılığı ve Metabolik Kontrol
Received Date : 21 Jun 2018
Accepted Date : 08 Jan 2019
Doi: 10.25179/tjem.2018-61916 - Makale Dili: EN
Turk J Endocrinol MetabTurk J Endocrinol Metab 2019;23:8-18
ABSTRACT
Objective: To assess insulin sensitivity and physical activity level (PAL) and their relationship with demographic, clinical, and laboratory parameters in patients with Type 1 diabetes mellitus (T1DM). Material and Methods: We evaluated 150 adults with T1DM using the International Physical Activity Questionnaire (IPAQ) to determine PAL and estimated glucose disposal rate (eGDR) for insulin sensitivity. The patients were divided into three groups according to PAL [inactive (n=48), moderately active (n=55), and highly active (n=47)] and into two groups according to eGDR [<8.16 mg·kg–1·min–1 [n=67] and ≥8.16 mg·kg–1·min–1 (n=83)]. Results: According to eGDR values, 4.6% of 150 patients were insulin resistant. Insulin resistant patients were older and heavier and had higher body mass index, waist circumference, blood pressure, and serum glycemic and lipid parameters than insulin sensitive patients, and had nephropathy and a family history of DM. No significant differences in PAL were found according to insulin sensitivity between the groups. According to eGDR values, highdensity lipoprotein cholesterol and glomerular filtration rate were positively correlated. In terms of clinical and metabolic parameters, except for gender distribution, no differences were found among the PAL groups. Conclusion: The prevalence of insulin resistance was high in Turkish adults with T1DM and a meaningful correlation was evident between eGDR and disease control parameters. PAL assessed by the IPAQ was similar between insulin-resistant and insulin-sensitive patients.
ÖZET
Amaç: Tip 1 diabetes mellitus (Tip 1 DM) lu hastalarda insülin duyarlılığı ve fiziksel aktivite düzeyi (PAL) ile bunların demografik, klinik ve laboratuvar parametreleri ile ilişkisini değerlendirmektedir. Gereç ve Yöntemler: PAL ve insülin duyarlılığı için tahmini glukoz atılım oranı (eGDR) nı belirlemek amacıyla Uluslararası Fiziksel Aktivite Anketi (IPAQ) kullanılarak 150 erişkin Tip 1 DM'li hasta değerlendirildi. Hastalar PAL’ye göre 3 gruba [inaktif (n=48), orta derecede aktif (n=55) ve yüksek derecede aktif (n=47)] ve eGDR'ye göre iki gruba [<8.16 mg·kg–1·min–1 (n=67) ve ≥8.16 mg·kg–1·min–1 (n=83)] ayrıldı. Bulgular: eGDR değerlerine göre, 150 hastanın %44,6'sı insülin dirençli idi. İnsülin dirençli hastalar; daha yaşlı ve kiloluydu, insülin duyarlı hastalardan daha yüksek beden kitle indeksi, bel çevresi, kan basıncı ve serum glisemik ve lipit parametrelerine sahipti ve diyabet aile öyküsü ve nefropatileri mevcuttu. Gruplar arasında insülin duyarlılığına göre PAL'de anlamlı farklılık bulunmadı. eGDR değerlerine göre; yüksek yoğunluklu lipoprotein, kolesterol ve glomerüler filtrasyon hızı ile pozitif korelasyon olduğu gösterildi. Klinik ve metabolik parametreler açısından cinsiyet dağılımı dışında PAL grupları arasında fark bulunamadı. Sonuç: Tip 1 DM'li Türk erişkinlerde, insülin direnci prevalansı yüksek idi ve eGDR ile hastalık kontrol parametreleri arasında anlamlı bir ilişki olduğu görüldü. IPAQ ile değerlendirilen PAL’nin insülin dirençli ve insülin duyarlı hastalarda benzer olduğu gözlendi.
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