Hemoglobin A1c, Physical Activity, And Sport Participation Among Children With Type 1 Diabetes

Abstract

Children with type 1 diabetes (T1D) should engage in a minimum of 60 minutes of moderate- to vigorous-intensity physical activity (PA) daily, the same as children without T1D; however, care must be taken to prevent or address hypoglycemia or hyperglycemia during and after PA. PURPOSE: The purpose of this study was to determine if PA or sport participation predicted hemoglobin A1c (HbA1c) in children with T1D. METHODS: This study was conducted within a nationally certified pediatric diabetes care and academic medical center. Patients 7 to 17 years old with T1D presenting for their regularly scheduled pediatric endocrinology appointment were invited to complete a physical activity and sport participation electronic survey. Data were linked to their medical records for age, T1D diagnosis duration, ethnicity, race, gender, insurance type, body mass index (BMI), continuous glucose monitor (CGM) and insulin pump usage, and the primary outcome variable HbA1c. RESULTS: Participants consisted of 73 females (47.7%) and 80 males (52.3%), 12.97 ± 2.82 years old, with an average HbA1c of 8.78 ± 1.87. They were physically active for 60 minutes or more 3.48 ± 1.95 days per week with only 7.9% (n = 12) meeting the recommendation of daily PA, yet almost two-thirds played sports within the past year (n = 98, 64.1%). A multiple linear regression model indicated that although HbA1c decreased by .175 for each day a child engaged in PA and decreased .121 for every sport team a child played only the number of days active per week was a significant predictor of better HbA1c (p < .05). CONCLUSION: Since the number of days active per week was a significant predictor of better HbA1c, it behooves diabetes care teams to encourage PA in addition to sport participation alone. Further investigation should address socioecological barriers to PA and sport participation. This study was made possible by support from the Christensen Family, Children’s Hospital Foundation, and University of Louisville Foundation.