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

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.