Feasibility and safety of a group physical activity program for youth with type 1 diabetes

Garrett I. Ash, Kevin L. Joiner, Mary Savoye, Julien S. Baker, James Gerosa, Emma Kleck, Neha S. Patel, Lois S. Sadler, Matthew Stults-Kolehmainen, Stuart A. Weinzimer, Margaret Grey

Research output: Contribution to journalArticle

Abstract

Background/Objective
Many adolescents with type 1 diabetes do not achieve 60 minutes of daily moderate to vigorous physical activity (MVPA). Recognizing the importance of peer influence during adolescence, we evaluated the feasibility and safety of a group MVPA intervention for this population.

Subjects

Eighteen adolescents with type 1 diabetes (age 14.1±2.3yr, female 67%, Black or Latino 67%, median body mass index 92%’ile, A1c 79.9±25.1 mmol/mol, 9.5±2.3%).

Methods
Intervention sessions (35min MVPA and 45min discussion) occurred 1x/week for 12 weeks. Feasibility and safety metrics were enrollment, completion of intervention and assessments, cost, and hypoglycemia rates. Participants completed MVPA (accelerometry), and exploratory nutritional, psychosocial, clinical, and fitness variable assessments at baseline, 3mo, and 7mo. Hedges’ effect sizes were calculated.

Results
Enrollment was 16% and intervention completion 56%. Assessment completion at 7mo was 67% for MVPA, nutrition, and fitness, 83% for psychosocial assessments, and 94% for clinical assessments. Cost was $1,241 per completing participant. One episode of mild hypoglycemia occurred during the sessions (0.6%). Self-reported daily fruit/vegetable servings (d= -0.72) and diabetes self-management behaviors decreased over time (d= -0.40). In the 10 completers, endurance run score improved (d= 0.49) from low baseline levels, while systolic blood pressure decreased (d= -0.75) and low-density lipoprotein increased (d= 0.49) but stayed within normal ranges.

Conclusions
The protocol for the group MVPA intervention was safe and had some feasibility metrics meriting further investigation. MVPA levels and glycemic control remained sub-optimal, suggesting the need for more intensive interventions for this population.

Original languageEnglish
Pages (from-to)1-10
Number of pages10
JournalPediatric Diabetes
Volume2019
Early online date4 Mar 2019
DOIs
Publication statusE-pub ahead of print - 4 Mar 2019

Fingerprint

Type 1 Diabetes Mellitus
Exercise
Safety
Hypoglycemia
Accelerometry
Blood Pressure
Costs and Cost Analysis
Physical Fitness
Self Care
LDL Lipoproteins
Hispanic Americans
Vegetables
Population
Fruit
Reference Values
Body Mass Index

Keywords

  • diabetes mellitus
  • adolescent
  • exercise
  • glycated haemoglobin A
  • behavior
  • type 1

Cite this

Ash, Garrett I. ; Joiner, Kevin L. ; Savoye, Mary ; Baker, Julien S. ; Gerosa, James ; Kleck, Emma ; Patel, Neha S. ; Sadler, Lois S. ; Stults-Kolehmainen, Matthew ; Weinzimer, Stuart A. ; Grey, Margaret . / Feasibility and safety of a group physical activity program for youth with type 1 diabetes. In: Pediatric Diabetes. 2019 ; Vol. 2019. pp. 1-10.
@article{9cd0fbf82d1a46c0920bd9cd739c2a31,
title = "Feasibility and safety of a group physical activity program for youth with type 1 diabetes",
abstract = "Background/ObjectiveMany adolescents with type 1 diabetes do not achieve 60 minutes of daily moderate to vigorous physical activity (MVPA). Recognizing the importance of peer influence during adolescence, we evaluated the feasibility and safety of a group MVPA intervention for this population. SubjectsEighteen adolescents with type 1 diabetes (age 14.1±2.3yr, female 67{\%}, Black or Latino 67{\%}, median body mass index 92{\%}’ile, A1c 79.9±25.1 mmol/mol, 9.5±2.3{\%}). MethodsIntervention sessions (35min MVPA and 45min discussion) occurred 1x/week for 12 weeks. Feasibility and safety metrics were enrollment, completion of intervention and assessments, cost, and hypoglycemia rates. Participants completed MVPA (accelerometry), and exploratory nutritional, psychosocial, clinical, and fitness variable assessments at baseline, 3mo, and 7mo. Hedges’ effect sizes were calculated. ResultsEnrollment was 16{\%} and intervention completion 56{\%}. Assessment completion at 7mo was 67{\%} for MVPA, nutrition, and fitness, 83{\%} for psychosocial assessments, and 94{\%} for clinical assessments. Cost was $1,241 per completing participant. One episode of mild hypoglycemia occurred during the sessions (0.6{\%}). Self-reported daily fruit/vegetable servings (d= -0.72) and diabetes self-management behaviors decreased over time (d= -0.40). In the 10 completers, endurance run score improved (d= 0.49) from low baseline levels, while systolic blood pressure decreased (d= -0.75) and low-density lipoprotein increased (d= 0.49) but stayed within normal ranges.ConclusionsThe protocol for the group MVPA intervention was safe and had some feasibility metrics meriting further investigation. MVPA levels and glycemic control remained sub-optimal, suggesting the need for more intensive interventions for this population.",
keywords = "diabetes mellitus, adolescent, exercise, glycated haemoglobin A, behavior, type 1",
author = "Ash, {Garrett I.} and Joiner, {Kevin L.} and Mary Savoye and Baker, {Julien S.} and James Gerosa and Emma Kleck and Patel, {Neha S.} and Sadler, {Lois S.} and Matthew Stults-Kolehmainen and Weinzimer, {Stuart A.} and Margaret Grey",
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Ash, GI, Joiner, KL, Savoye, M, Baker, JS, Gerosa, J, Kleck, E, Patel, NS, Sadler, LS, Stults-Kolehmainen, M, Weinzimer, SA & Grey, M 2019, 'Feasibility and safety of a group physical activity program for youth with type 1 diabetes' Pediatric Diabetes, vol. 2019, pp. 1-10. https://doi.org/10.1111/pedi.12841

Feasibility and safety of a group physical activity program for youth with type 1 diabetes. / Ash, Garrett I. ; Joiner, Kevin L. ; Savoye, Mary ; Baker, Julien S.; Gerosa, James ; Kleck, Emma ; Patel, Neha S. ; Sadler, Lois S. ; Stults-Kolehmainen, Matthew ; Weinzimer, Stuart A. ; Grey, Margaret .

In: Pediatric Diabetes, Vol. 2019, 04.03.2019, p. 1-10.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Feasibility and safety of a group physical activity program for youth with type 1 diabetes

AU - Ash, Garrett I.

AU - Joiner, Kevin L.

AU - Savoye, Mary

AU - Baker, Julien S.

AU - Gerosa, James

AU - Kleck, Emma

AU - Patel, Neha S.

AU - Sadler, Lois S.

AU - Stults-Kolehmainen, Matthew

AU - Weinzimer, Stuart A.

AU - Grey, Margaret

PY - 2019/3/4

Y1 - 2019/3/4

N2 - Background/ObjectiveMany adolescents with type 1 diabetes do not achieve 60 minutes of daily moderate to vigorous physical activity (MVPA). Recognizing the importance of peer influence during adolescence, we evaluated the feasibility and safety of a group MVPA intervention for this population. SubjectsEighteen adolescents with type 1 diabetes (age 14.1±2.3yr, female 67%, Black or Latino 67%, median body mass index 92%’ile, A1c 79.9±25.1 mmol/mol, 9.5±2.3%). MethodsIntervention sessions (35min MVPA and 45min discussion) occurred 1x/week for 12 weeks. Feasibility and safety metrics were enrollment, completion of intervention and assessments, cost, and hypoglycemia rates. Participants completed MVPA (accelerometry), and exploratory nutritional, psychosocial, clinical, and fitness variable assessments at baseline, 3mo, and 7mo. Hedges’ effect sizes were calculated. ResultsEnrollment was 16% and intervention completion 56%. Assessment completion at 7mo was 67% for MVPA, nutrition, and fitness, 83% for psychosocial assessments, and 94% for clinical assessments. Cost was $1,241 per completing participant. One episode of mild hypoglycemia occurred during the sessions (0.6%). Self-reported daily fruit/vegetable servings (d= -0.72) and diabetes self-management behaviors decreased over time (d= -0.40). In the 10 completers, endurance run score improved (d= 0.49) from low baseline levels, while systolic blood pressure decreased (d= -0.75) and low-density lipoprotein increased (d= 0.49) but stayed within normal ranges.ConclusionsThe protocol for the group MVPA intervention was safe and had some feasibility metrics meriting further investigation. MVPA levels and glycemic control remained sub-optimal, suggesting the need for more intensive interventions for this population.

AB - Background/ObjectiveMany adolescents with type 1 diabetes do not achieve 60 minutes of daily moderate to vigorous physical activity (MVPA). Recognizing the importance of peer influence during adolescence, we evaluated the feasibility and safety of a group MVPA intervention for this population. SubjectsEighteen adolescents with type 1 diabetes (age 14.1±2.3yr, female 67%, Black or Latino 67%, median body mass index 92%’ile, A1c 79.9±25.1 mmol/mol, 9.5±2.3%). MethodsIntervention sessions (35min MVPA and 45min discussion) occurred 1x/week for 12 weeks. Feasibility and safety metrics were enrollment, completion of intervention and assessments, cost, and hypoglycemia rates. Participants completed MVPA (accelerometry), and exploratory nutritional, psychosocial, clinical, and fitness variable assessments at baseline, 3mo, and 7mo. Hedges’ effect sizes were calculated. ResultsEnrollment was 16% and intervention completion 56%. Assessment completion at 7mo was 67% for MVPA, nutrition, and fitness, 83% for psychosocial assessments, and 94% for clinical assessments. Cost was $1,241 per completing participant. One episode of mild hypoglycemia occurred during the sessions (0.6%). Self-reported daily fruit/vegetable servings (d= -0.72) and diabetes self-management behaviors decreased over time (d= -0.40). In the 10 completers, endurance run score improved (d= 0.49) from low baseline levels, while systolic blood pressure decreased (d= -0.75) and low-density lipoprotein increased (d= 0.49) but stayed within normal ranges.ConclusionsThe protocol for the group MVPA intervention was safe and had some feasibility metrics meriting further investigation. MVPA levels and glycemic control remained sub-optimal, suggesting the need for more intensive interventions for this population.

KW - diabetes mellitus

KW - adolescent

KW - exercise

KW - glycated haemoglobin A

KW - behavior

KW - type 1

U2 - 10.1111/pedi.12841

DO - 10.1111/pedi.12841

M3 - Article

VL - 2019

SP - 1

EP - 10

JO - Pediatric Diabetes

JF - Pediatric Diabetes

SN - 1399-543X

ER -