Author(s): PATIENCE, M., KIRK, A., JANSSEN, X., SANDERS, J., CRAWFORD, M., Institution: UNIVERSITY OF STRATHCLYDE, Country: UNITED KINGDOM, Abstract-ID: 1289

INTRODUCTION:
Adolescents with type 1 diabetes (T1D) are required to manage their condition throughout the entire 24-hour day. Physical activity, sedentary behaviour and sleep (24-hour movement behaviours) all play a crucial role in the management of T1D [1], yet no research has explored adolescents with T1Ds perceptions towards all three behaviours collectively. The aims of this study are to conduct a mixed method study to explore adolescents with T1D perceptions of 24-hour movement behaviours (24-h MBs) and assess the amount of time they engage in each behaviour.
METHODS:
Qualitative data was gathered using semi-structured interviews. These were recorded, transcribed using intelligent verbatim and analysed using thematic analysis. Quantitative data was gathered using a wrist-worn accelerometery (GT3X-BT). The Hildebrand cut-points were used to categorise sedentary behaviour (SB), <35.6 mg/1s, light physical activity (LPA), ≥35.6 mg/1s and moderate-vigorous physical activity (MVPA), ≥201.5-706.9 mg/1s, while the Van Heest heuristic algorithm was used to estimate sleep.
RESULTS:
In total 15 adolescents (6M, 9F) participated with mean age 14.6±2.0yrs, HbA1c 7.4±1.0%, diabetes duration 3.7±3.1yrs. Most used a continuous glucose monitor (80%) and delivered insulin by pump (67%). The main themes arising from the data were: 1) adolescents understanding of 24-h MBs (indicating awareness of how one behaviour impacts the other); 2) adolescents perception of 24-h MBs on mood (indicating better sleep and increased physical activity had a positive impact on mood, whereas sedentary behaviour had a negative impact) and 3) adolescents perceptions of 24-h MBs impact on blood glucose (mixed perceptions on their relation to blood glucose levels). Average sedentary time was 9.8±1.7h/d, LPA time was 5.6±1.4h/d, MVPA time was 28.5±27min/d and sleep time was 8.1± 0.7h/night. Most of the sample did not meet the MVPA recommendations (91.1%) while 58.3% met the sleep duration recommendations.

CONCLUSION:
This study highlights adolescents with T1Ds understanding of the interconnectedness of each behaviour within a 24-hour day and the positive impact the correct balance of each behaviour can have on mood/emotions. Despite this, a large proportion of adolescents with T1D in this study are not meeting the 24-hour movement behaviour recommendations. The results from this study promote the use of a holistic 24-hour movement behaviour approach in the management of T1D and can inform future interventions aiming to support healthy 24-hour movement behaviours in this population.

1. Patience, M, et al., 24-hour movement behaviours (physical activity, sedentary behaviour and sleep) association with glycaemic control and psychosocial outcomes in adolescents with type 1 diabetes: a systematic review of quantitative and qualitative studies. International Journal of Environmental Research and Public Health, 2023. 20(5): p.4363.