**8. Conclusions**

glucose concentrations are < 120 mg/dl. It also seems that treatment with 15 g of oral glucose is insufficient to reliably treat hypoglycemia during exercise in children and adolescents [88]. Our results showed significantly higher frequency of hyperglycemic events in GrR compared to GrS, with similar amount of hypoglycemic events. It is worth pointing out that GrR exhibited lower glucose levels in the morning whereas hyperglycemia usually appeared in the after‐ noons and evenings. This coincided with the distribution of physical activities during the camp. In the morning children performed low-intensity exercise of longer duration while the

Our investigations revealed that, compared to dietary standards for children, our study participants showed an excessive intake of proteins and fats and very low carbohydrate intake. Children with T1DM do not meet the standards of basic nutrients consumption [106]. The energy intake from proteins, fat and of carbohydrates compared to dietary standards for children showed an excessive intake of proteins and fats and very low carbohydrate intake. The analysis of variance showed a significant effect of age on the level of fat consumption and

Increased intake of fat and protein and lower carbohydrate values can cause problems with

It should be mentioned, that proper nutrition is important in the prevention and treatment of chronic complications of diabetes [107-110]. According to clinical guidelines [71] 40-50% of energy should provide carbohydrate diet, especially a low glycemic index (<50 IG), the fats should provide 30-35% of the energy value of the diet; and protein should be 15-20 %. The ratio of animal protein to vegetable protein should be at least 50/50%. For important recommenda‐ tions should supplement meals with fluids, vitamins, minerals and fiber [32]. Despite the important role of a balanced diet in the treatment of T1DM, standard recommendations that could help clinicians manage glycemia during exercise are still lacking [111]. The type, duration, and timing of exercise as well as its temporal relation to meals and premeal insulin doses may affect glucose homeostasis during and after exercise. Moreover, regulation of blood glucose associated with physical exercise and anabolic hormonal secretion could be important for long-term glycemic control [112-113]. In the above mentioned studies glycated hemoglobin (HbA1c) could be a better index of long-term glucose homeostasis than measuring fasting and/

The results of the previous study suggested improvement in long-term glycemic control in T1DM youth after a programme of physical activity [10, 105] associated with an increase in aerobic capacity or fitness. Austin et al. [103] also observed a negative correlation between

Consistent with these findings, our data also indicated a tendency to HbA1c levels increase in children with lower physical activity (GrS) compared to summer camp participants (GrR).

Our results also demonstrate that participation in an organized rehabilitation programme increased the daily energy expenditure and was associated with tendency to lowering indices

aerobic physical effort and HgA1c levels and daily insulin doses in diabetic patients.

positive correlation between the value of energy intake and insulin dose.

insulin administration in response to diet and/or physical activity.

intensity of afternoon exercise was higher.

84 Glucose Homeostasis

or post-challenge glucose [69-70, 73].

Regular physical activity is an essential element in blood glucose regulation for children and adolescents with type 1 diabetes mellitus. The obtained results indicate that children with type 1 diabetes are not meeting recommended physical activity and dietary guidelines, and especially regarding fat intake. Regular physical activity with high energy expenditure may effectively control glucose homeostasis as documented by HbA1c reduction. However, incorrect dietary behaviors and/or exercise load in T1DM patients may increase the risk of hypo-or hyperglycemia and long-term metabolic complications.
