Abstract:Impact of Moderate-to-vigorous Physical Activity on Continuous Glucose Monitor-derived Metrics in Youth with Type 1 Diabetes
Kelsey Panfil1, Erin M. Tallon1, Brent Lockee1, David D. Williams1, Susana R. Patton2, Mark A. Clements1
1Children’s Mercy Kansas City (Kansas City, MO), 2Nemours Children's Health, (Jacksonville, FL)
Background and Aims: Regular moderate-to-vigorous physical activity (MVPA) offers many health benefits and may lower glycemia in youth with type 1 diabetes (T1D). We examined relationships between continuous blood glucose (CBG), time in range (TIR), and coefficient of variation (CV) in youth with T1D whose mean daily MVPA was in the highest, versus lowest, quartiles of measured daily physical activity.
Methods: We analyzed aggregated CGM and wearable fitness tracker data from 231 U.S. youth (T1D duration ≥3 months) enrolled in a 10-day, real-world observational study, the Type 1 Diabetes EXercise Initiative Pediatric Study (T1-DEXIP). After calculating and rank-ordering participants by mean daily minutes of MVPA, we used two-sample t-tests to compare mean CBG, TIR, and CV in youth in the top and bottom quartiles of the sample.
Results: In the T1-DEXIP cohort (median age 14[3 IQR] years; 58.4% male; 83.2% non-Hispanic White; 57.6% pump users), mean±SD daily minutes of MVPA in the upper and lower quartiles were 83.7±26.0 and 5.7±3.2, respectively. The top quartile was 84.5% male; the bottom quartile was 77.6% female. While there were no marked differences in mean CBG between quartiles, youth in the top quartile had lower mean TIR (65.57%) than the bottom quartile (68.65%; t=-2.44; [95% CI, (-5.55)-(-0.60)]). Mean CV for youth in the top quartile (0.34) was greater than for the bottom quartile (0.31; t=4.44 [95% CI, 0.01-0.03]).
Conclusions: In this cohort, increased MVPA associated with modestly decreased TIR but increased CV. Further evaluation of the immediate and long-term clinical significance of these findings is needed.