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Brian D. Tran and Pietro Galassetti

The beneficial effects of exercise, including reduction of cardiovascular risk, are especially important in children with type 1 diabetes (T1DM), in whom incidence of lifetime cardiovascular complications remains elevated despite good glycemic control. Being able to exercise safely is therefore a paramount concern. Dysregulated metabolism in T1DM however, causes frequent occurrence of both hypo- and hyperglycemia, the former typically associated with prolonged, moderate exercise, the latter with higher intensity, if shorter, challenges. While very few absolute contraindications to exercising exist in these children, exercise should not be started with glycemia outside the 80–250 mg/dl range. Within this glycemic range, careful adjustments in insulin administration (reduction or infusion rate via insulin pumps, or overall reduction of dosage of multiple injections) should be combined with carbohydrate ingestion before/during exercise, based on prior, individual experience with specific exercise formats. Unfamiliar exercise should always be tackled with exceeding caution, based on known responses to other exercise formats. Finally, gaining a deep understanding of other complex exercise responses, such as the modulation of inflammatory status, which is a major determinant of the cardio-protective effects of exercise, can help determine which exercise formats and which individual metabolic conditions can lead to maximally beneficial health effects.

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Stefano Palermi, Anna M. Sacco, Immacolata Belviso, Nastasia Marino, Francesco Gambardella, Carlo Loiacono and Felice Sirico

hyperglycemia . SMAES, 11, 225 . Retrieved from Mak , M.K. , & Ng , P.L. ( 2003 ). Mediolateral sway in single-leg stance is the best discriminator of balance performance for Tai-Chi practitioners . Archives of Physical Medicine and Rehabilitation

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Sara Knaeps, Stijn De Baere, Jan Bourgois, Evelien Mertens, Ruben Charlier and Johan Lefevre

Background: The purpose of the current study was to apply a more novel approach to systematically examine (1) associations of clustered cardiometabolic risk and cardiometabolic risk factors and (2) theoretical substitution of sedentary time with either sleep, light physical activity (LPA), or moderate to vigorous physical activity (MVPA) and substituting LPA with MVPA. Methods: Physical activity and sleep were objectively measured in 410 Flemish adults [55.5 (9.6) y, 64% men] with a SenseWear Pro 3 Armband. Cardiometabolic risk factors (obesity, hyperglycemia, dyslipidemia, and hypertension) and cardiorespiratory fitness were objectively measured. Isotemporal substitution analyses were performed to assess the associations between substituting time from a potentially negative behavior into another potentially positive behavior. Results: Theoretical substitution of sedentary time with MVPA was associated with decreased clustered cardiometabolic risk, b = −0.06 (−0.08 to −0.04), and substituting LPA with MVPA was associated with a decrease in clustered cardiometabolic risk, b = −0.08 (−0.11 to −0.04). Substituting sedentary time with LPA or sleep improved high-density lipoprotein-cholesterol, systolic and diastolic blood pressures, and waist circumference. Conclusion: Theoretical replacement of sedentary time with either sleep, LPA, or MVPA was positively associated with improved cardiometabolic risk factor status. Interventions for increasing cardiometabolic health can focus on replacing sedentary time with either sleep, LPA, or MVPA depending on the risk parameters that need to be targeted.

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Andrzej Gawrecki, Aleksandra Araszkiewicz, Agnieszka Szadkowska, Grzegorz Biegański, Jan Konarski, Katarzyna Domaszewska, Arkadiusz Michalak, Bogda Skowrońska, Anna Adamska, Dariusz Naskręt, Przemysława Jarosz-Chobot, Agnieszka Szypowska, Tomasz Klupa and Dorota Zozulińska-Ziółkiewicz

activity among diabetic patients, it was very important to develop safety rules for players during a mass sports event. The most important goal for medical care was to avoid decompensation of diabetes, that is, severe hypoglycemia or hyperglycemia with ketosis. A greater risk of ketoacidosis occurs in

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Vera K. Tsenkova, Chioun Lee and Jennifer Morozink Boylan

Diabetes is a significant problem in the United States and accounts for substantial morbidity and mortality. Currently, 9.3% have diabetes and 37% have milder forms of hyperglycemia such as prediabetes that typically transition to overt diabetes. 1 The economic costs of diabetes are staggering

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and >200 mg/dL) during the various races. Secondary outcomes were percentages of time spent in euglycemia (70 mg/dl–200 mg/dL), hypoglycemia (<70 mg/dL) and hyperglycemia (>200 mg/dL) during the PRs and marathon. Results.— Twelve patients (2 women, 10 men), median age 40YO; with a median HbA1C at 7

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Yuri Alberto Freire, Geovani de Araújo Dantas de Macêdo, Rodrigo Alberto Vieira Browne, Luiz Fernando Farias-Junior, Ágnes Denise de Lima Bezerra, Ana Paula Trussardi Fayh, José Cazuza de Farias Júnior, Kevin F. Boreskie, Todd A. Duhamel and Eduardo Caldas Costa

Health . 2018 ; 15 ( 4 ): 279 – 286 . PubMed ID: 29421968 doi:10.1123/jpah.2017-0251 10.1123/jpah.2017-0251 29421968 36. Levitan EB , Song Y , Ford ES , Liu S . Is nondiabetic hyperglycemia a risk factor for cardiovascular disease? A meta-analysis of prospective studies . Arch Intern Med

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Kin-Kit Li, Lorna Ng, Sheung-Tak Cheng and Helene H. Fung

hyperglycemia, cardiovascular incidents, and injuries and foot complications ( Sigal, Kenny, Wasserman, Castaneda-Sceppa, & White, 2006 ). For individuals who perceive PA as risky, loss-framed messages may be more effective than gain-framed messages. For instance, Bassett-Gunter, Martin Ginis, and Latimer

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Saowaluck Suntraluck, Hirofumi Tanaka and Daroonwan Suksom

diabetes mellitus is characterized by hyperglycemia due to insulin resistance, which over time leads to a myriad of micro- and macrovascular complications ( Caballero et al., 1999 ), including endothelial dysfunction and arterial stiffening ( Sena, Pereira, & Seica, 2013 ). Land-based exercise training has

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Samuel G. Wittekind, Nicholas M. Edwards, Philip R. Khoury, Connie E. McCoy, Lawrence M. Dolan, Thomas R. Kimball and Elaine M. Urbina

assigned to unmodifiable risk factors (age and gender) and modifiable risk factors (cholesterol, smoking, BP, BMI, and hyperglycemia) and totaled to predict the likelihood of such lesions. 28 This score has been used to predict early atherosclerosis detected by CIMT in adolescents and young adults. 29