Different amounts of moderate to vigorous physical activity and change in glycemic variability in adolescents with type 1 diabetes: is there dose-response relationship?

Rebesco, Denise Barth; Nesi-França, Suzana; Lima, Valderi Abreu de; Leite, Neiva; Smouter, Leandro; Souza, William Cordeiro de; Komatsu, William Ricardo; Mascarenhas, Luís Paulo Gomes

doi:10.20945/2359-3997000000254

Cited by 7 publications

(9 citation statements)

References 27 publications

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“…But our study does not align with at least one other cross‐sectional study observing that the amount of physical activity performed by an adolescent with T1D does not impact various CGM metrics, such as the mean glucose, the low blood glucose index or the high blood glucose index significantly 25 . In that previous study, 25 however, glycemia was only shown to be comparable between active days and sedentary days within a child, while we determined if the activity levels on active days influences glycemia across the cohort. Based on our findings, we propose that each 200 MET‐minute increase in daily activity (roughly equivalent to 30 min of vigorous exercise) on active days, one to two times per week, may be associated with a 7% increase in TIR for a child living with T1D who is not meeting current physical activity guidelines.…”

Section: Discussioncontrasting

confidence: 99%

“…The present study supports previous work suggesting that adolescents with T1D who accumulate ~60 min of physical activity on three or more days per week have better glucose control, as measured by HbA1c levels, when compared to those who accumulate less activity 23,24 . But our study does not align with at least one other cross‐sectional study observing that the amount of physical activity performed by an adolescent with T1D does not impact various CGM metrics, such as the mean glucose, the low blood glucose index or the high blood glucose index significantly 25 . In that previous study, 25 however, glycemia was only shown to be comparable between active days and sedentary days within a child, while we determined if the activity levels on active days influences glycemia across the cohort.…”

Section: Discussioncontrasting

confidence: 91%

“…23,24 But our study does not align with at least one other cross-sectional study observing that the amount of physical activity performed by an adolescent with T1D does not impact various CGM metrics, such as the mean glucose, the low blood glucose index or the high blood glucose index significantly. 25 In that previous study, 25 however, glycemia was only shown to be comparable between active days and sedentary days within a child, while we determined if the activity levels on active days influences glycemia across the cohort.…”

Section: Discussionmentioning

confidence: 91%

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Association between high levels of physical activity and improved glucose control on active days in youth with type 1 diabetes

Gal

Willi

et al. 2022

Pediatric Diabetes

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Background: Sixty minutes per day of at least moderate to vigorous physical activity (MVPA) is recommended for children for a variety of physical and psychological reasons. Adherence to these guidelines is confounded by challenges with glucose control during exercise in type 1 diabetes (T1D).Objectives: This study examined the potential association between physical activity level on active days and glucose control in youth with T1D.Methods: Blinded continuous glucose monitors (CGM: Abbott Libre Pro) and physical activity data as measured from a body monitor patch (Metria IH1) were collected for up to 3 weeks in youth aged 9-17 years with T1D. The association between physical activity levels, expressed as mean active metabolic equivalent minutes (MET-minutes) per day, with CGM-based mean glucose, percent time in range (TIR: 70-180 mg/dl), % time above range (TAR) and % time below range (TBR) were assessed using a linear regression model adjusted for age, gender, and baseline HbA1c.Results: Study participants were deemed physically active, as defined by at least 10 min of continuous moderate-to-vigorous activity, on 5.2 ± 1.9 days per week, with a median accumulated physical activity time of 61 [IQR: 37-145] minutes per day. Higher physical activity levels were associated with lower mean glucose levels (r = À0.36; p = 0.02) and lower TAR (r = À0.45; p = 0.002) on active days. Higher activity levels were also associated with greater TIR (r = 0.54; p < 0.001) without being associated with more, or less, TBR.Conclusions: Higher amounts of physical activity are associated with improvements in TIR without significantly increasing TBR. These data suggest that youth ages 9-17 years with T1D can benefit from a high level of physical activity without undue fear of hypoglycemia.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussioncontrasting

confidence: 91%

Section: Discussionmentioning

confidence: 91%

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Association between high levels of physical activity and improved glucose control on active days in youth with type 1 diabetes

Gal

Willi

et al. 2022

Pediatric Diabetes

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“…CGM data have been used to better help understand the relationship between daily activities, behaviors, and glucose control including diets and eating patterns [34][35][36][37][38][39], exercise or activities [40][41][42][43][44][45][46][47][48][49][50], sleep [51][52][53], amount of time spent at home (eg, before and during the COVID-19 lockdown) [54], and externalizing behaviors [55].…”

Section: Using Cgm To Identify Relationships Between Daily Factors and T1d Symptoms And Behaviorsmentioning

confidence: 99%

Technological Ecological Momentary Assessment Tools to Study Type 1 Diabetes in Youth: Viewpoint of Methodologies

Ray¹,

McMichael²,

Rivera-Santana³

et al. 2021

JMIR Diabetes

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Type 1 diabetes (T1D) is one of the most common chronic childhood diseases, and its prevalence is rapidly increasing. The management of glucose in T1D is challenging, as youth must consider a myriad of factors when making diabetes care decisions. This task often leads to significant hyperglycemia, hypoglycemia, and glucose variability throughout the day, which have been associated with short- and long-term medical complications. At present, most of what is known about each of these complications and the health behaviors that may lead to them have been uncovered in the clinical setting or in laboratory-based research. However, the tools often used in these settings are limited in their ability to capture the dynamic behaviors, feelings, and physiological changes associated with T1D that fluctuate from moment to moment throughout the day. A better understanding of T1D in daily life could potentially aid in the development of interventions to improve diabetes care and mitigate the negative medical consequences associated with it. Therefore, there is a need to measure repeated, real-time, and real-world features of this disease in youth. This approach is known as ecological momentary assessment (EMA), and it has considerable advantages to in-lab research. Thus, this viewpoint aims to describe EMA tools that have been used to collect data in the daily lives of youth with T1D and discuss studies that explored the nuances of T1D in daily life using these methods. This viewpoint focuses on the following EMA methods: continuous glucose monitoring, actigraphy, ambulatory blood pressure monitoring, personal digital assistants, smartphones, and phone-based systems. The viewpoint also discusses the benefits of using EMA methods to collect important data that might not otherwise be collected in the laboratory and the limitations of each tool, future directions of the field, and possible clinical implications for their use.

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“…Whether similar results would be observed in a pediatric population with type 1 diabetes mellitus is unknown. To our knowledge, only one study has looked specifically at the relationship between glucose variability and intensity levels of exercise or physical activity duration [ 16 ]. However, prior investigations have not examined this relationship in a habitually active pediatric population with type 1 diabetes mellitus.…”

Section: Introductionmentioning

confidence: 99%

Association between Intensity Levels of Physical Activity and Glucose Variability among Children and Adolescents with Type 1 Diabetes

Jaggers

King

McKay

et al. 2023

IJERPH

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Studies would indicate a reduction in hemoglobin A1c levels following moderate and/or vigorous physical activity (PA) for people managing diabetes. However, prior investigations rarely looked at glucose variability in an adolescent population. Purpose: The purpose of this investigation was to test the relationship between physical activity intensity levels and glucose variability in a sample of adolescents with type 1 diabetes mellitus, and if the amount of time accumulated for each intensity level is predictive of changes in glucose variability. Methods: Glucose variability was determined using continuous glucose monitor data and physical activity intensity time was retrieved through Fitabase®. Both glucose and physical activity data were collected over a two-week timeframe. Data analysis was completed using Pearson’s correlation and a simple linear regression with a p-value of 0.05 to determine significance. Results: A significant inverse relationship was observed (p = 0.04) between glucose variability and average minutes of daily moderate-intensity activity (r = −0.59), as well as moderate and vigorous physical activity (MVPA) combined (r = −0.86; p = 0.03). A simple linear regression indicated that only MVPA was a significant predictor of glucose variability (β = −0.12; 95% CI: −0.23–−0.01, p = 0.03). Conclusion: These data demonstrated that the total amount of daily physical activity is important when properly managing type 1 diabetes mellitus, but time spent in MVPA over two weeks may have an inverse relationship with glucose variability in children and adolescents over a span of two weeks.

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Different amounts of moderate to vigorous physical activity and change in glycemic variability in adolescents with type 1 diabetes: is there dose-response relationship?

Cited by 7 publications

References 27 publications

Association between high levels of physical activity and improved glucose control on active days in youth with type 1 diabetes

Association between high levels of physical activity and improved glucose control on active days in youth with type 1 diabetes

Technological Ecological Momentary Assessment Tools to Study Type 1 Diabetes in Youth: Viewpoint of Methodologies

Association between Intensity Levels of Physical Activity and Glucose Variability among Children and Adolescents with Type 1 Diabetes

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