Objective: The Teamwork, Targets, Technology, and Tight Range (4T) Exercise Program evaluated physical activity patterns across the first year of type 1 diabetes diagnosis and whether physical activity was associated with changes in glucose outcomes in the 24 h following physical activity.
Research design and methods: The 4T Exercise Program started newly diagnosed youth with type 1 diabetes on a continuous glucose monitoring (CGM) system and physical activity tracker around 1 month postdiagnosis. A subset of youth opted to participate in up to four quarterly structured exercise education sessions to increase their knowledge around safe physical activity.
Results: Ninety-eight youth with type 1 diabetes (median [interquartile range (IQR)] age of 13 [12-15] years, 45% female, 44% non-Hispanic White) completed the study. Compared with sedentary days, days with ≥10 min of vigorous intensity physical activity were associated with an increase in time in range (TIR) of 2.3% (1.4-3.2%; P < 0.001), a decrease in time above range (TAR) of 3.1% (2.2-4.0%; P < 0.001), and an increase in time below range (TBR) of 0.8% (0.6-0.9%; P < 0.001) in the 24 h following physical activity. From 1-3 months to 10-12 months postdiagnosis, the median (IQR) step count increased by 1,134 (445-1,519) steps per day (P < 0.001), while daily moderate-to-vigorous physical activity increased by 11 (2-23) min per day (P < 0.001).
Conclusions: In the 24 h following physical activity as compared with sedentary days, TIR improved, TAR was lower, and TBR remained within clinical target recommendations. For youth with new-onset type 1 diabetes, each structured exercise education session was associated with a further 0.79% increase in TIR.
© 2025 by the American Diabetes Association.