227-OR: Physical Activity and Glucose Control among Youth with T1D

Abstract

Background: Challenges with exercise related glucose control in type 1 diabetes (T1D) may impact adherence to guidelines which recommend 60 minutes daily of moderate to vigorous intensity aerobic activity for youth ages 6-17 years. We examined the association between physical activity and glucose control in youth with T1D. Methods: Interstitial glucose data from flash continuous glucose monitors (CGM, Abbott Diabetes Care’s Freestyle Libre Pro Flash Glucose Monitor) and physical activity data (Metria IH1 activity patch) were objectively measured. Data from 52 youth 9-17 years old with a median diabetes duration of 6 years (IQR: 3 to 8) and mean (±SD) HbA1c of 9.1 ± 1.5% were analyzed. Partial Pearson’s correlation coefficients adjusting for age, gender, and baseline HbA1c were used to assess the association between daily physical activity and glucose control; the primary analysis used a linear regression model adjusted for age, gender, and baseline HbA1c. Results: Participants with higher average energy expenditure, as measured by metabolic equivalent minutes (MET-min), on their active days had higher average % time in range (TIR: 70-180 mg/dL) in the 24 hours after exercise than participants with lower average MET-min on active days (p<0.001). For individuals with <200 average daily MET-min, TIR was 26% ± 21%, while TIR was 34% ± 14% for those with 200 to <600 average MET-min, and 49% ± 14% for those with ≥600 average MET-min. Percent time >180 mg/dL decreased with increased activity (p=0.002). Activity was significantly associated with lower mean glucose (p=0.02) without an increase in % time <70 mg/dL or % time <54 mg/dL. Conclusions: Among youth with T1D, objectively measured physical activity levels are associated with improved glucose control and decreased hyperglycemia. Use of biometric technology, such as activity trackers, may motivate youth to be more physically active, but integration with other diabetes-specific technologies, such as CGM and insulin pumps, may offer solutions for improved blood sugar management. Disclosure J. Gal: None. Z. Li: None. S. M. Willi: Advisory Panel; Self; Boehringer Ingelheim International GmbH, Medtronic, Other Relationship; Self; National Institute of Diabetes and Digestive and Kidney Diseases. M. Riddell: Advisory Panel; Self; Zealand Pharma A/S, Consultant; Self; Lilly Diabetes, Research Support; Self; Dexcom, Inc., Insulet Corporation, Speaker’s Bureau; Self; Novo Nordisk Inc., Sanofi, Stock/Shareholder; Self; Zucara Therapeutics Inc. Funding The Leona M. and Harry B. Helmsley Charitable Trust