Barriers to Physical Activity in Children and Adults Living With Type 1 Diabetes: A Complex Link With Real-life Glycemic Excursions

Parent, Cassandra; Lespagnol, Elodie; Berthoin, Serge; Tagougui, Sémah; Heyman, Joris; Stuckens, C.; Gueorguieva, Iva; Balestra, Costantino; Tonoli, Cajsa; Kozon, Bérengère; Fontaine, P.; Weill, Jacques; Rabasa‐Lhoret, Rémi; Heyman, Elsa

doi:10.1016/j.jcjd.2022.10.006

Cited by 13 publications

(5 citation statements)

References 45 publications

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“…The details of the NICE criteria, as well as the setup of the CGM Academy, have been detailed in our previous reports [13,14]. In brief, NICE hypoglycaemia criteria for initiation of CGM included (1)(2)(3)(4)(5).…”

Section: Methodsmentioning

confidence: 99%

“…Unsurprisingly, fear of hypoglycaemia (FoH) for CYPD can pose a major barrier to being active [3]. Additionally, FoH heightens if the CYPD has experienced nocturnal hypoglycaemia related to physical activity [4]. International consensus guidance for exercise management for CYPD provides recommendations for hypoglycaemia prevention while promoting the long-term benefits of being physically active throughout life [5].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

et al. 2023

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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.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2023

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“…Additionally, this study associated a higher activity level with lower mean glucose levels ( P = .02) and a better TIR ( P < .001), without being accompanied by more hypoglycaemic events. On the other hand, children and adolescents in particular perceive the risk of hypoglycaemia as a greater barrier to exercise the more they have previously suffered from hypoglycaemia on nights after physical activity 12 . Conclusively, despite the scientifically proven benefits of exercise in T1D, the psychological fear of hypoglycaemia and losing glycaemic control seems to be the major barrier for children, adolescents and their parents to engaging in regular exercise 9,12 …”

Section: Introductionmentioning

confidence: 99%

“…On the other hand, children and adolescents in particular perceive the risk of hypoglycaemia as a greater barrier to exercise the more they have previously suffered from hypoglycaemia on nights after physical activity. 12 Conclusively, despite the scientifically proven benefits of exercise in T1D, the psychological fear of hypoglycaemia and losing glycaemic control seems to be the major barrier for children, adolescents and their parents to engaging in regular exercise. 9,12 Studies need to show that with adequate support it is possible for children and adolescents with T1D to participate in a variety of sports, without the risk of hypoglycaemia.…”

Section: Introductionmentioning

confidence: 99%

“…12 Conclusively, despite the scientifically proven benefits of exercise in T1D, the psychological fear of hypoglycaemia and losing glycaemic control seems to be the major barrier for children, adolescents and their parents to engaging in regular exercise. 9,12 Studies need to show that with adequate support it is possible for children and adolescents with T1D to participate in a variety of sports, without the risk of hypoglycaemia. Therefore, the aim of this twocentre, prospective, randomized controlled trial was to explore the safety via the time below glucose range 1 (TBR1: 54-69 mg/dL; 3.0-3.9 mmol/L) and efficacy via the time in range (TIR: 70-180 mg/ dL; 3.9-10.0 mmol/L) of a 4-week intervention of intensive glycaemic management with or without track and field training in adolescents with T1D.…”

Section: Introductionmentioning

confidence: 99%

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Impact of a 4‐week intensive track and field training intervention on glycaemia in adolescents with type 1 diabetes: The ChilDFiT1 study

Zimmer,

Birnbaumer,

Sternad

et al. 2023

Diabetes Obesity Metabolism

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AimTo investigate the safety and efficacy of track and field training compared with intensification of insulin treatment only in adolescents with type 1 diabetes (T1D).Materials and MethodsEighteen adolescents (seven females) with T1D were included (age 15.1 ± 1.1 years, HbA1c 7.3% ± 1.0% [56.3 ± 10.9 mmol/mol]). After a 4‐week observational control phase, participants were randomized to either stand‐alone intensive glycaemic management (IT; telemedicine or on‐site visits, three times/week) or additionally performed track and field exercise (EX; three 60‐minute sessions/week) for 4 weeks. Glycaemia was assessed via continuous glucose monitoring during observational control and intervention phases.ResultsTime in range (70‐180 mg/dL; 3.9‐10.0 mmol/L) significantly improved from the observational control phase to the exercise intervention phase in EX (69% ± 13% vs. 72% ± 11%, P = .049), but not in IT (59% ± 22% vs. 62% ± 16%, P = .399). Time below range 1 (54‐69 mg/dL; < 3.9 mmol/L) improved in IT (3.1% ± 1.9% vs. 2.0% ± 0.8%, P = .017) and remained stable in EX (2.0% ± 1.7 vs. 1.9% ± 1.1%, P = .999). The EX group's HbA1c ameliorated preintervention to postintervention (mean difference: ΔHbA1c −0.19% ± 0.17%, P = .042), which was not seen within the IT group (ΔHbA1c −0.16% ± 0.37%, P = .40). Glucose standard deviation was reduced significantly in EX (55 ± 11 vs. 51 ± 10 mg/dL [3.1 ± 0.6 vs. 2.8 ± 0.6 mmol/L], P = .011), but not in IT (70 ± 24 vs. 63 ± 18 mg/dL [3.9 ± 1.3 vs. 3.5 ± 1.0 mmol/L], P = .186).ConclusionTrack and field training combined with intensive glycaemic management improved glycaemia in adolescents with T1D, which was not observed in the non‐exercise group.

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Nutrition in type 1 diabetes

Gölz,

Haller

2024

Diabetologie

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Barriers to Physical Activity in Children and Adults Living With Type 1 Diabetes: A Complex Link With Real-life Glycemic Excursions

Cited by 13 publications

References 45 publications

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

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

Impact of a 4‐week intensive track and field training intervention on glycaemia in adolescents with type 1 diabetes: The ChilDFiT1 study

Nutrition in type 1 diabetes

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