INTRODUCTION
Type 2 diabetes is a leading cause of disease-associated comorbidity and complications. The disease is caused by various factors, mainly genetic and environmental. Additionally, there are key drivers in the development of the disease, including impaired insulin secretion, insulin resistance, and altered glucose-insulin homeostasis. Many people with type 2 diabetes are also likely to be obese due to a shared, altered glucose-insulin homeostasis factor. Although the onset of the disease is primarily in adults, there has been an increased incidence and prevalence of type 2 diabetes in youth. In the past 8 years until 2017, the prevalence of type 2 diabetes in 1000 youths aged 10-19 years has increased from 0.46 (2009) to 0.67 (2017). On a racial basis, the Alaskan Natives lead with 80% prevalence, the non-Hispanic blacks with 37.6%, Hispanic youth with 35.2%, and the Pacific Islander youth with 34.2% (Chiang et al., 2018). According to incidence data, non-Hispanic blacks lead with an incidence of 46.5/ 100 000/ year.
The proposed project in the previous assignment aimed at reducing the spread of diabetes among the young generation, which is already becoming a norm in the community. This literature review will discuss physical activity as a lifestyle intervention to manage type 2 diabetes. Physical activity can reduce the risk factors of obesity, heart disease, and type 2 diabetes among youth. This literature review drove me to conduct insufficient evidence of physical activities’ benefits on microvascular complications, glycaemic control, and the significant risk of harm through hypoglycemia. The literature review will focus on physical activity and health in type I diabetes. The literature review will follow a systematic order that will examine the effect several outcomes from physical activity have on well-being, overall mortality, glycaemic control, lipids, diabetic complications, beta cell function, osteoporosis and cancer, and blood pressure.
MAIN BODY
There are various pieces of research and articles that have generally discussed type 2 diabetic prevention in the general population. However, the literature review focuses on a specific youth population. The references on the reference page have been used to develop this paper. When conducting the research, I searched for interventions to utilize and increase physical activity to manage type one diabetes. Apart from the secondary sources provided on the reference page, I borrowed insights from PubMed, MEDLINE, and the Centers for Diseases Control and Prevention (CDC). The keywords that I focused on in the literature selection were ‘type 1 diabetes and ‘physical activities.’ The inclusion criteria were based on the earlier outcome categories identified, interventions, and population. The population is the youth with type 2 diabetes, and interventions that increase physical activities impact outcomes such as well-being, overall mortality, glycaemic control, lipids, diabetic complications, and blood pressure.
Benefits of Physical Activities in Various Type 1 Diabetes Outcomes
- Physical Fitness:
Many studies have been conducted before to investigate the relationship between type 1 diabetes and fitness. However, in the ones conducted, young adults aged 17-44 with type 1 diabetes are less fit than those without type diabetes (Chiang et al., 2018). The reason is abnormalities in the cardiac muscle and autonomic nerve function. Ironically, the youth would suffer greatly from a lack of physical activities and be a significant concern in the prevalence of type 1 diabetes. However, reflecting on the technological advancement in the food industry and sports, possible reasons explain it. The invention of modern food preservation is doing more harm than the earlier anticipated benefits. The effects of the consumption of ready-made food rich in fats and other growth-enhancing products are causing overweight which leads to obesity. Street food is deep fried in oil, rich in fat that accumulates in our bodies. Consequently, it puts us at risk of cardiovascular diseases, obesity, and type 1 diabetes. Additionally, there has been an alarming reduction in outdoor activities as more video games continue to be invented.
A perfect solution to preventing type 1 diabetes among youth is supervised physical activity programs. These programs could start in schools by ensuring every institution has physical education classes. Besides, the state and local governments should coordinate in setting aside lands for recreational activities and sports. Social halls should also be set aside to accommodate indoor games such as badminton, table tennis, and skating.
- Glycaemic Control and Insulin Requirements:
Physical activity can improve glycaemic control in patients with diabetes. However, it depends on the duration and intensity of the physical activities. Through physical activities, the HBA level in diabetic youth reduces by about 0.6% (4.2 mmol/mol) (Tornese et al., 2020). When it comes to insulin, it is greatly reduced. Physical activity that lasts for less than five months could fail to show the effectiveness of physical activities in managing insulin and glycemia (Zaharieva et al., 2020). If physical activities can rely on it, they must be intense and carried out consistently for a longer time. I think physical activities controlling glycaemic and insulin do not give better outcomes than others because increased energy consumption during physical activities in type 1 diabetic youth counteracts any glucose-lowering effect.
Although various studies have found a relationship between reduced insulin requirements and physical activity, a clear result should be defined as whether incorporating a proper dietary program alongside physical activities could be the best therapy for insulin and glycemic management (Boom & Mader, 2020). The certain thing under this outcome is that physical activities can be conducted safely and with minimal hypoglycemia. Additionally, type 1 diabetic youth could adopt regular moderate-intensity exercise to manage their diabetic condition.
- Well-being:
In type 1 diabetes, the incidence is higher compared to the general population. Many studies agree that physical activity is associated with well-being and greater satisfaction. However, it is only beneficial to young adults and adults, which falls under the interest of this review. Depression has been observed in type 1 and types 2 diabetes. Regular physical activities act as a getaway from stress (Zaharieva et al., 2020). The youth are in vulnerable years and likely to experience thoughts of adversity and feelings of emptiness, rejection, and disillusionment. Engaging in regular activities would save them from stress, and physical activities reduce stress hormones and enhance the production of hormone-like dopamine- a happiness hormone.
- Beta cell function, osteoporosis, and cancer:
The preservation of beta cells enhances the management of glucose and reduces long-term complications of the rate of hypoglycemia with more than half rate. Physical activity could be helpful in healthy individuals and youth with type 1 diabetes. In a deeper explanation, by acting on the number of functions of immune cells, physical activities impart a global-inflammatory effect. Although I was interested in knowing whether physical activity had potential income osteoporosis and management of type 1 diabetes among the youth, none of the studies showed any relationship. However, physical activity has an impact on cancer. Cancer is a serious complication when diagnosed alongside type 1 diabetes. Physical activity can protect the youth from cancer and improve recovery and outcomes from subsequent prevention of chemotherapy recurrence and side effects.
- CVD and Mortality:
According to current trends, CVD has increased in type 1 and type 2 diabetes. There is a close association between CVD and low levels of physical activity. Cardiovascular diseases (CVD) are risk factors and co-occur alongside type 2 diabetes. Managing either of them could treat both. Referring to one of the studies I used to develop this literature review, youth who participated in high school and college sports are three times more likely to report type 1 diabetes and CVD than their counterparts (Bullard et al., 2019). Besides, their mortality rates are three times lower than those who do not participate in sports.
Therefore, physical activity is associated with reduced CVD (a significant risk factor) among youth with type 1 diabetes. It stresses why the education sector, the health system, and the government should work together to broaden the incorporation of physical activity programs in schools and neighborhoods.
Additionally, there are more points to note from the literature review;
Despite the fact that people with type 1 diabetes benefit greatly from physical activity, their overall blood glucose control is not improved without an efficient balance of insulin dose and food intake to maintain euglycemia before, during, and after exercise of all types. Insulin users who want to exercise while maintaining good blood glucose control have access to several technological advancements. However, these devices still have some drawbacks. Finding ways to incorporate all of the available data to maximize blood glucose control and performance during and after exercise will probably involve the development of “smart” calculators, improved closed-loop systems that can utilize additional inputs and learn, and social aspects that allow devices to meet the needs of the users, furthermore to continued improvements to existing technologies and introduction of new ones (Bullard et al., 2019). The only challenges that could prevail in ` the execution of such a health intervention are a lack of coordination among key stakeholders and inadequate funds.
CONCLUSION
Physical activity has positive outcomes in the identified entities that impact type 1 diabetes among the youth. It improves strength, fitness, and well-being and reduces insulin requirements and cardiovascular risk factors. However, the relationship between physical activity and glycaemic control requires additional research to demonstrate it. Based on my project proposal, my findings through this literature review affirms that physical activity has potential benefits in managing type 1 diabetes among the youth. The youth are the pillars of economic, social, and political pillars. Their contribution is needed, and their health is of great concern. Educating the youth and the general population could help reduce the incidence and prevalence of type 1 diabetes. I credit the reliability of the below-utilized sources in formulating my literature review on the benefits of physical activity in managing and preventing type 1 diabetes among the youth.
REFERENCES
Bullard, T., Ji, M., An, R., Trinh, L., Mackenzie, M., & Mullen, S. P. (2019). A systematic review and meta-analysis of adherence to physical activity interventions among three chronic conditions: cancer, cardiovascular disease, and diabetes. BMC public health, 19(1), 1–11.
Chiang, J. L., Maahs, D. M., Garvey, K. C., Hood, K. K., Laffel, L. M., Weinzimer, S. A., … & Schatz, D. (2018). Type 1 diabetes in children and adolescents: a position statement by the American Diabetes Association. Diabetes care, 41(9), 2026-2044.
Moser, O., Riddell, M. C., Eckstein, M. L., Adolfsson, P., Rabasa-Lhoret, R., van den Boom, L., … & Mader, J. K. (2020). Glucose management for exercise using continuous glucose monitoring (CGM) and intermittently scanned CGM (isCGM) systems in type 1 diabetes: a position statement of the European Association for the Study of Diabetes (EASD) and the International Society for Pediatric and Adolescent Diabetes (ISPAD) endorsed by JDRF and supported by the American Diabetes Association (ADA). Diabetologia, 63(12), 2501-2520.
Rulla Alsaedi, Kimberly McKeirnan; Literature Review of Type 2 Diabetes Management and Health Literacy. Diabetes Spectr 1 November 2021; 34 (4): 399–406. https://doi.org/10.2337/ds21-0014.
Tornese, G., Ceconi, V., Monasta, L., Carletti, C., Faleschini, E., & Barbi, E. (2020). Glycemic control in type 1 diabetes mellitus during COVID-19 quarantine and the role of in-home physical activity. Diabetes technology & therapeutics, 22(6), 462-467.
Zaharieva, D. P., Messer, L. H., Paldus, B., O’Neal, D. N., Maahs, D. M., & Riddell, M. C. (2020). Glucose control during physical activity and exercise using closed-loop technology in adults and adolescents with type 1 diabetes. Canadian journal of diabetes, 44(8), 740-749.
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