Moderate-to-vigorous exercise may worsen HbA1c levels in young type 1 diabetes patients with obesity

The researchers state, "as physical activity is crucial to weight management and cardiovascular health, further studies are required to determine better the mechanism underlying this association to find out how to best support young adults with type 1 diabetes and obesity or overweight in their efforts to increase physical activity."

Utilizing data from the ACT1ON study, Franklin R. Muntis from the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA, and colleagues conducted secondary analyses to examine the relationship between minutes of moderate-to-vigorous physical activity (MVPA) and glycemia in obese adults with type 1 diabetes.

They found that greater habitual weekly moderate-to-vigorous physical activity (MVPA) minutes were linked with higher HbA1c levels, reduced time in range, and higher time above range.

Sixty-six participants with type 1 diabetes provided measures of percent of time below range <70 mg/dL, glycemia (hemoglobin A1c [HbA1c], time above range [TAR >180 mg/dL]), time-in-range [TIR 70–180 mg/dL], self-reported physical activity (Global Physical Activity Questionnaire [GPAQ] and Previous Day Physical Activity Recalls [PDPAR]) at baseline, 3, 6, and 9 months post-intervention. For a subset of 27 participants, wearable activity data was available. Associations were determined using mixed effects regression models after adjusting for demographic, design, dietary, and clinical covariates.

The study revealed the following findings:

• Among young adults, 19–30 years of age with a baseline HbA1c of 7.9% ± 1.4% and body mass index of 30.3 (interquartile range 27.9, 33.8), greater habitual weekly MVPA minutes were associated with higher HbA1c through the GPAQ and wearable activity data.
• The authors did not observe a significant association between habitual MVPA and continuous glucose monitoring metrics.
• Using PDPAR data, greater daily MVPA minutes were shown to be associated with more TAR and reduced TIR on the day following reported physical activity.

"Increased moderate-to-vigorous physical activity in young adults with type 1 diabetes and obesity is linked with worsened glycemia," the authors concluded.

Reference:

Franklin R. Muntis, Daria Igudesman, Angelica Cristello Sarteau, Joan Thomas, Nora Arrizon-Ruiz, Julie Hooper, Ananta Addala, Jamie L. Crandell, Michael C. Riddell, David M. Maahs, Richard E. Pratley, Karen Corbin, Elizabeth J. Mayer-Davis, Dessi P. Zaharieva, on behalf of the ACT1ON Consortium, Katherine J. Souris, Brenda Santana, Jessica Shipley, Franziska K. Bishop, Korey Hood, Kyle S. Burger, Ashley K. Irwin, Garry Steil, Michael R. Kosorok, Ian Carroll, Steven Smith, Anna Kahkoska, Erika Puelo, Keri Whitaker, Anna Casu, Teeranan Pokaprakarn, and Sue Kirkman.Relationship Between Moderate-to-Vigorous Physical Activity and Glycemia Among Young Adults with Type 1 Diabetes and Overweight or Obesity: Results from the Advancing Care for Type 1 Diabetes and Obesity Network (ACT1ON) Study.Diabetes Technology & Therapeutics.Dec 2022.881-891.http://doi.org/10.1089/dia.2022.0253