Date of Award:

5-1981

Document Type:

Thesis

Degree Name:

Master of Science (MS)

Department:

Nutrition, Dietetics, and Food Sciences

Committee Chair(s)

Barbara Prater

Committee

Barbara Prater

Committee

Bonita Wyse

Committee

Donald Sisson

Abstract

There is evidence for the importance of physical exercise balanced with diet and insulin therapy in the treatment and control of Type I insulin-dependent diabetes mellitus. Recent attention in the literature has focused on the once neglected component of treatment--exercise. A well-controlled exercise state is generally believed to be beneficial for the individual with diabetes. Limited studies are available on the effect of exercise on long-term metabolic control. Before exercise levels can be professionally prescribed for a given population of youth with diabetes, current exercise patterns should be evaluated as to the effect on long-term metabolic control.

It is the purpose of this study to examine the effects of exercise balanced with diet and insulin therapy on long-term metabolic control measured by total glycosylated hemoglobin values. The 26 subjects in the study were all Type I insulin-dependent youth with diabetes mellitus. The subjects ranged from 8 to 17 years of age. Sixteen subjects were female and 10 were male. All subjects were Diabetic Clinic outpatients of Primary Children Medical Center located in Salt Lake City, Utah.

The research design utilized both descriptive design and statistical analysis. Questionnaries were used by the researcher to collect the data. Described were demographic data, nutrient intake, clinic staff assessment of metabolic control, and growth parameters. Statistical analysis using a one-way analysis of variance test was performed to determine relationships between the dependent variable, total glycosylated hemoglobin, and the independent variables--exercise levels, caloric adequacy, insulin dosage administration, and metabolic control assessment. Further statistical tests were completed utilizing the least significant difference test.

Among the described data, nutrient intake and growth parameters were compared to standards of a normal non-diabetic population. The nutrient intake of the subjects was well below the standard for iron. Iron was predominantly below the Recommended Dietary Allowance in the female subgroup, 11 to 14 years of age, with only 18 percent meeting the 1980 Recommended Dietary Allowance for iron. The growth parameters of the subjects were fairly equally distributed when compared to a normal population. The females showed some growth retardation with four of 16 females (25 percent) falling at or below the 5th percentile for either height or weight.

It was found that a majority (88 percent) of the Type I insulin-dependent youth sampled were participating in regular exercise. Further examination of the subjects' exercise patterns demonstrated an influence of exercise on long-term metabolic control. Statistical significance at the 10 percent level was found between the three exercise levels and total glycosylated hemoglobin values. Individuals participating in predominantly moderately heavy activity (7.0-8.0 METS) had the highest degree of metabolic control. The results of the study support the conclusion that physical exercise has an important effect in the long-term metabolic control of youth with Type I insulin-dependent diabetes.

A highly statistical significance was found between the clinic staff metabolic control assessment and total glycosylated hemoglobin values. Statistical significance was not found among the other two treatments. Caloric adequacy data failed to show statistical significance with total glycosylated hemoglobin. Insulin dosage administration data also failed to demonstrate a statistical significance with glycosylated hemoglobin.

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