Association of Physical Activity and Socioeconomic Status With Glycaemic Control in Adults With Type 1 Diabetes: A Cross-Sectional Study Using CGM Data.

Higher physical activity was independently associated with better glycaemic control in adults with type 1 diabetes.

• The highest physical activity quartile was associated with +8.0% time in range (TIR) compared to lower activity groups (p < 0.01).
• The highest activity quartile was associated with -0.47% HbA1c (p < 0.01).
• Physical activity was assessed via the short-form International Physical Activity Questionnaire (IPAQ) in 423 adults with T1D.
• Glycaemic outcomes were derived from continuous glucose monitoring (CGM) and included TIR, time in tight range (TITR), and HbA1c.
• Multivariable linear models were used to assess independent associations after adjustment.

Higher income (socioeconomic status) was independently associated with better glycaemic control.

• SES was estimated using mean annual net income by census tract.
• Higher income was independently associated with better glycaemic control in multivariable models.
• The study used a cross-sectional design with 423 adults from a public healthcare setting.
• No significant interaction between SES and physical activity on glycaemic outcomes was observed.

Physical activity partially mediated the effect of income on time in range.

• Four-way mediation analyses were conducted to examine the mediating role of physical activity in the SES-glycaemia relationship.
• The pure indirect effect of income on TIR through physical activity was β = 2.42 (p = 0.013).
• Physical activity accounted for approximately 23% of the total effect of income on TIR.
• No significant SES-activity interaction was observed in the mediation analysis.

Physically active individuals had lower insulin requirements independent of income.

• Physically active individuals had a 16% lower insulin requirement compared to less active individuals.
• This association was independent of income level.
• The finding was derived from the same cross-sectional cohort of 423 adults with T1D.

Physically active individuals had a better lipid profile independent of income.

• Better lipid profiles were observed in physically active individuals regardless of income level.
• This association was identified in multivariable analyses controlling for SES.
• The specific lipid parameters were assessed in the same cohort of 423 adults with T1D.

A modest increase in time below range (TBR) was observed with physical activity but without longer hypoglycaemia duration.

• Physical activity was associated with a modest TBR increase.
• This increase occurred without longer hypoglycaemia episodes.
• The finding suggests physical activity benefits on glycaemic control are not substantially offset by hypoglycaemia risk in this population.