Regular weight-bearing physical activity improves total body (TB) and lumbar spine bone mineral accretion in children with type 1 diabetes mellitus (DM) in a magnitude similar to that in healthy patients. The improvement is not associated with variation in bone biochemical markers.
Maggio and coworkers conducted a randomized controlled trial that included 27 children with DM and 32 healthy children; both were randomized to an exercise or a control group. At baseline and 9 months, TB, lumbar spine (L2-4), femoral neck, and greater trochanter areal BMD (aBMD) and serum bone biomarkers (osteocalcin, type 1 collagen cross-linking) were measured. The intervention consisted of two 90-minute sessions per week of weight-bearing physical activity (ball games, jumping, rope skipping, and gymnastics).
At 9 months, changes in TB and L2-4 aBMD were statistically significant in the intervention groups and of similar magnitude between children with type 1 DM and healthy children. The level of type 1 collagen cross-linking decreased in the intervention groups but was not associated with TB aBMD changes.
The authors suggested that children with type 1 DM be encouraged to practice regular physical activity to enhance peak bone mass and prevent osteoporosis later in life.