Youth with type 1 diabetes mellitus are more inactive and sedentary than apparently healthy peers: a systematic review and meta-analysis

Aims: To conduct a meta-analysis of differences in physical activity, sedentary behaviour, and physical fitness between children and adolescents with type 1 diabetes and their healthy peers. Methods: The databases EMBASE, PubMed and SportsDiscus were searched for studies. Pooled effects were calculated using random effects inverse-variance models with the Hartung–Knapp–Sidik–Jonkman adjustment. Results: Thirty-five studies were included, comprising a total of 4,751 youths (53% girls, 2,452 with type 1 diabetes). Youth with type 1 diabetes were less physically active (Cohen’s d = − 0.23, 95%CI − 0.42 to − 0.04), more sedentary (Cohen’s d = 0.33, 95%CI 0.06 to 0.61), and had lower cardiorespiratory fitness (Cohen’s d = − 0.52, 95%CI − 0.73 to − 0.31) than their healthy peers. This corresponds to –12.72 min/day of moderate-tovigorous physical activity, 63.3 min/day of sedentary time (accelerometry) and –4.07 ml/kg/min of maximum/peak oxygen consumption. In addition, young people with type 1 diabetes were less likely to meet the international physical activity recommendations than their healthy peers (odds ratio = 0.44, 95%CI 0.31 to 0.62). Conclusions: Keeping in mind the heterogeneity between studies in the design, population and assessment, our findings show that children and adolescents with type 1 diabetes seem to be less active, more sedentary, and have lower cardiorespiratory fitness levels than their healthy peers.