Endocrine Abstracts

Objectives: Investigate the effect of using moderate intensity activity between meals to lower hyperglycaemia on glucose metrics in children and young people with type 1 diabetes (CYPD).

Design & Methods: Retrospective data from CYPD attending a continuous glucose monitoring (CGM) education programme at a tertiary centre between 2019 and 2022 were analysed. CYPD were taught to use moderate intensity activity to lower hyperglycaemia between meals (to less than 10.0 mmol/L by using 10-15 minutes for every 2 mmol/L). CYPD >5 years with minimum 6 month data and at least 70% CGM data capture were included. CYPD <2 years from diagnosis were excluded due to honeymoon effect. Data were collected on demographics and baseline and six months 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), TAR2 (>13.9 mmol/L)]. At six months, information on minutes of activity used to lower glucose level > 14.0 mmol/L trending steady was gathered through a self-reported questionnaire. CYPD were grouped into low (<5 minutes), mild (5-10 minutes), or moderate (11-20 minutes) activity groups.

Results: 125 (n= 53, 40% male) CYPD with a mean (SD) age of 12.3 (±3.7) years and diabetes duration of 7.0 (±3.7) years were included. Baseline HbA1c was 58.5 (± 8.7) mmol/mol. 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), TAR (29.9% vs. 38.3% vs. 45.3%, P<0.001) and TAR2 (7.6% vs.11.0% vs. 16.1%, P<0.001) were significantly different across the moderate, mild, and low activity groups, respectively. No differences were found for TBR (2.16% vs. 2.32% vs. 2.58%, P=0.408) across groups. CYPD in the low activity group were younger, predominantly females, and from the most deprived socioeconomic quintile. Moderate intensity activity is more likely to be used by males and older age groups.

Conclusion: Moderate intensity activity to lower hyperglycaemia between meals improves glycaemic control without increasing risk of hypoglycaemia in CYPD. Socio-economic barriers to implementation need further exploring.