Physical Activity in Very Young Children Living with Type 1 Diabetes

Physical activity has health benefits for people living with type 1 diabetes (T1D); however, there are barriers limiting their ability to meet minimum recommended levels of moderate-to-vigorous physical activity (MVPA). We aimed to measure physical activity levels and barriers to physical activity in children <7 years of age living with T1D and compare to general population data and guidelines.

Children <7 years of age with T1D were recruited from two paediatric diabetes centres in Australia. Physical activity was measured for 7 days using an accelerometer. Parents completed questionnaires related to barriers to physical activity (Barriers to Physical Activity in Diabetes [BAPAD1]) and fear of hypoglycaemia (Hypoglycaemia Fear Survey-Parents of Young Children [HFS-PYC]). Continuous glucose monitor (CGM) data were collected. MVPA was compared to the general population.

Thirty-three children, mean age 4.5 years (SD 1.2), mean HbA1c 7.1% (SD 1.1) (55 mmol/mol [SD 13]), and mean diabetes duration 35 months (SD 21), participated. Children with and without T1D did not meet daily MVPA recommendations and mean MVPA was not significantly different between groups (42.6 min [SD 26.02] vs. 42.8 min [SD 17.05], p = 0.972). CGM time in range 3.9-10 mmol/L correlated with MVPA (Tau-b = 0.396, p = 0.19). The median (Q1, Q3) for BAPAD1 average score was 2.4 (2, 4) and median HFS behaviour and worry sub-scores were both low at 2.3 (2, 3).

Children <7 years of age did not meet the recommended daily MVPA level independent of diabetes. Parental concern regarding diabetes-related barriers to physical activity was low.