None listed
Conditions
Brief summary
Despite the key role of exercise in preventing the cardiovascular complications that shorten life expectancy in people with type 1 diabetes (T1D), children with T1D are less active and less physically fit than their peers. Evidence for how to change this situation is lacking. A validated method to systematically measure activity levels in youth with T1D is thus needed. This project therefore seeks to assess the validity, in youth with T1D, of three currently available child physical activity questionnaires by measuring their performance against objective accelerometry and in so doing, and thus identify a valid self-report questionnaire tool for measuring physical activity in youth with T1D for clinical use. We intend to embed the best of these tools into clinical care for youth with T1D. Applications envisioned include the (i) longitudinal assessment of activity levels in youth (ii) educating youth on exercising safely, (iii) design intervention trials to find optimal methods to increase exercise levels at all ages, and (iv) to prescribe personalised and specific exercise for those whose physical activity levels fall over time.
Interventions
This is an observational study, involving eligible patients attending the diabetes service’s outpatient clinics. The physical activity (PA) levels of the patients will be evaluated subjectively using three PA questionnaires, and compared against objective measurements of PA using the Actigraph GT3x (7, 8, 9)- a research grade triaxial accelerometer measured over the previous 7 days.
We will test the validity of three tools in this project:
1) Physical Activity Questionnaire for Older Children
This is an observational study, involving eligible patients attending the diabetes service’s outpatient clinics. The physical activity (PA) levels of the patients will be evaluated subjectively using three PA questionnaires, and compared against objective measurements of PA using the Actigraph GT3x (7, 8, 9)- a research grade triaxial accelerometer measured over the previous 7 days. We will test the validity of three tools in this project: 1) Physical Activity Questionnaire for Older Children (PAQ-C)/Physical Activity Questionnaire for Adolescents (PAQ-A). 2) The Previous Day Physical Activity Recall (PDPAR) 3) The single item tool adapted from Procheska et al PA will be measured objectively using a triaxial accelerometer using the Actigraph GT3x- a research grade triaxial accelerometer (https://www.actigraphcorp.com/support/activity-monitors/gt3x/) used in many trials to measure duration and intensity of PA in both youth and adults. In addition, as a secondary aspect of the study, we will explore the associations between components of PA and contemporaneous glucose control through the collection of continuous glucose monitoring (CGM) data in those youth wearing CGM devices during the period corresponding to actigraphy wear time. Participants will be required to wear the Actigraph GT3x (triaxial accelerometer) which will be secured on the hip via an elastic band for a period of 7-days. Data from the Actigraph GT3x will be recorded on a continuous basis in epoch lengths of 0.25 minutes. At the end of the 7-day wearing period, participants will complete all three PA questionnaires in a randomised order. Participants should be able to complete all three PA questionnaires in 30-minutes. CGM data will only be collected from pre-exisitng CGM device users who consent to their data being used as a secondary analysis for this project. Participants who are not currently using CGM devices will continue with the study as per usual and no CGM devices will be provided. CGM data will be recorded over the 7-day period in 5-minute intervals to determine measurements of glycaemic variability (percentage time-in-range; %TIR and coefficient of variation; CV).
Sponsors
Child and Adolescent Health Service
Eligibility
Sex/Gender
All
Age
8 Years to 17 Years
Healthy volunteers
No
Inclusion criteria
Children and adolescents with type 1 diabetes meeting 2 or more of the following criteria: 1. documented positive islet autoantibodies to T1D 2. C-peptide <0.05 nmol/L 3. permanent insulin requirement
Exclusion criteria
1. English not primary language 2. Comorbidities that substantially impact ability to perform exercise. 3. Individuals with reduced cognitive capacity who do not have capacity to adhere to the study protocol
Outcome results
None listed