Integrating Physical Activity Strategies to Lower Hyperglycaemia in Structured Education Programmes for Children and Young People with Type 1 Diabetes Improves Glycaemic Control without Augmenting the Risk of Hypoglycaemia

Abstract

Objectives. Investigate the effect of using short bursts of moderate-intensity activity between meals to lower hyperglycaemia on glucose metrics. Design and Methods. Children and young people with type 1 diabetes (CYPD) attending continuous glucose monitoring education were taught to use moderate-intensity activity to lower high glucose levels (to <10.0 mmol/L using 10–15 minlowers ∼2.0 mmol/L) between meals. Retrospective cross-sectional data analysis of CYPD at a single tertiary centre between 2019 and 2022. Data were collected on demographics and glucose metrics (HbA1c, time in range (TIR, 3.9–10.0 mmol/L), time above range (TAR, >10.0 mmol/L), time below range (TBR, <3.9 mmol/L)). Minutes of activity usually performed to lower a glucose level of 14.0 mmol/L trending steady at 6 months grouped the CYPD into low (<5 min), mild (5–10 min), or moderate (11–20 min) activity groups. Results. 125 (n = 53, 40% male) CYPD with a mean (standard deviations) age of 12.3 (±3.7) years and diabetes duration of 7.0 ± 3.7 years were included. HbA1c improved from 58.5 (±8.6) mmol/mol at baseline to 54.9 (±7.2) mmol/mol at 6 months ( $p<0.001$ ). Low, mild, and moderate activity was reported by 30% (n = 37), 34% (n = 43), and 36% (n = 45), respectively. At 6 months, HbA1c (52.0 vs. 54.3 vs. 59.4 mmol/mol, $p<0.001$ ), TIR (68.0% vs. 59.71 vs. 51.1%, $p<0.001$ ) and TAR (29.9% vs. 38.3% vs. 45.3%, $p<0.001$ ) were significantly different across the moderate, mild, and low activity groups, respectively. No association was found for TBR (2.16% vs. 2.32% vs. 2.58%, $p=0.408$ ) across groups. Conclusion. Increasing the use of moderate-intensity activity to lower hyperglycaemia between meals is associated with improved glucose control without increasing hypoglycaemia for CYPD.