Aims/hypothesis

Adults with type 1 diabetes should perform daily physical activity to help maintain health and fitness, but the influence of daily step counts on continuous glucose monitoring (CGM) metrics are unclear. This analysis used the Type 1 Diabetes Exercise Initiative (T1DEXI) dataset to investigate the effect of daily step count on CGM-based metrics.

Methods

In a 4 week free-living observational study of adults with type 1 diabetes, with available CGM and step count data, we categorised participants into three groups—below (<7000), meeting (7000–10,000) or exceeding (>10,000) the daily step count goal—to determine if step count category influenced CGM metrics, including per cent time in range (TIR: 3.9–10.0 mmol/l), time below range (TBR: <3.9 mmol/l) and time above range (TAR: >10.0 mmol/l).

Results

A total of 464 adults with type 1 diabetes (mean±SD age 37±14 years; HbA_1c 48.8±8.1 mmol/mol [6.6±0.7%]; 73% female; 45% hybrid closed-loop system, 38% standard insulin pump, 17% multiple daily insulin injections) were included in the study. Between-participant analyses showed that individuals who exceeded the mean daily step count goal over the 4 week period had a similar TIR (75±14%) to those meeting (74±14%) or below (75±16%) the step count goal (p>0.05). In the within-participant comparisons, TIR was higher on days when the step count goal was exceeded or met (both 75±15%) than on days below the step count goal (73±16%; both p<0.001). The TBR was also higher when individuals exceeded the step count goals (3.1%±3.2%) than on days when they met or were below step count goals (difference in means −0.3% [p=0.006] and −0.4% [p=0.001], respectively). The total daily insulin dose was lower on days when step count goals were exceeded (0.52±0.18 U/kg; p<0.001) or were met (0.53±0.18 U/kg; p<0.001) than on days when step counts were below the current recommendation (0.55±0.18 U/kg). Step count had a larger effect on CGM-based metrics in participants with a baseline HbA_1c ≥53 mmol/mol (≥7.0%).

Conclusions/interpretation

Our results suggest that, compared with days with low step counts, days with higher step counts are associated with slight increases in both TIR and TBR, along with small reductions in total daily insulin requirements, in adults living with type 1 diabetes.

Data availability

The data that support the findings reported here are available on the Vivli Platform (ID: T1-DEXI; https://doi.org/10.25934/PR00008428).

Graphical Abstract

中文翻译：

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1 型糖尿病成人每日步数分类与连续血糖监测指标之间的关联：1 型糖尿病运动计划 (T1DEXI) 队列分析

目标/假设

成人 1 型糖尿病患者应进行日常体育活动以帮助保持健康和健身，但每日步数对连续血糖监测 (CGM) 指标的影响尚不清楚。该分析使用 1 型糖尿病运动计划 (T1DEXI) 数据集来研究每日步数对基于 CGM 指标的影响。

方法

在一项针对 1 型糖尿病成人的为期 4 周的自由生活观察研究中，利用可用的 CGM 和步数数据，我们将参与者分为三组：低于 (<7000)、达到 (7000-10,000) 或超过 (>10,000)每日步数目标 — 确定步数类别是否影响 CGM 指标，包括范围内时间百分比 (TIR: 3.9–10.0 mmol/l)、低于范围的时间 (TBR: <3.9 mmol/l) 和高于范围的时间 (TAR) ：>10.0 毫摩尔/升）。

结果

共有 464 名成人 1 型糖尿病患者（平均±标准差，年龄 37±14 岁；HbA _1c 48.8±8.1 mmol/mol [6.6±0.7%]；73% 女性；45% 混合闭环系统，38% 标准胰岛素研究中包括泵、17%每日多次胰岛素注射）。参与者之间的分析显示，在 4 周内超过平均每日步数目标的个人的 TIR (75±14%) 与达到 (74±14%) 或低于 (75±16%) 步数的人相似目标（p >0.05）。在参与者内部比较中，超过或达到步数目标的日子（均为 75±15%）的 TIR 高于低于步数目标的日子（73±16%；均为p <0.001）。当个人超过步数目标 (3.1%±3.2%) 时，TBR 也高于达到或低于步数目标的日子（平均值差异 -0.3% [ p =0.006] 和 -0.4% [ p = 0.001]，分别）。超过步数目标（0.52±0.18 U/kg；p <0.001）或达到目标（0.53±0.18 U/kg；p <0.001）的每日胰岛素总剂量低于步数低于目标的日子当前建议（0.55±0.18 U/kg）。对于基线 HbA1c _≥53 mmol/mol (≥7.0%) 的参与者，步数对基于 CGM 的指标有较大影响。

结论/解释

我们的结果表明，与步数较少的日子相比，步数较高的日子与 1 型糖尿病成人的 TIR 和 TBR 略有增加有关，同时每日胰岛素总需求量略有减少。

数据可用性

支持此处报告的调查结果的数据可在 Vivli 平台上获取（ID：T1-DEXI；https://doi.org/10.25934/PR00008428）。

图形概要