Background: Barriers to moderate-to-vigorous physical activity (MVPA) for adolescents with type 1 diabetes (T1D) include physiology, transition to autonomy, and diabetes-specific stigma. Opportunities for T1D peer activities with T1D role model support are limited. To address this need, our single-arm pilot study tested Virtual Exercise Games for Youth with T1D (ExerT1D) for feasibility.
Method: The program included an MVPA videogame, physician-led education regarding managing T1D around MVPA, objective habitual MVPA goal-setting, and T1D management skills guided by young adult instructors living with T1D.
Results: Fifteen adolescents (median age 15.4 (IQR 14.5 - 16.4) years, 7 non-Hispanic white, 7 male, median HbA1c 7.8% (IQR 7.4%-11.2%) enrolled; 13 attended 83% of sessions. Participants rated the program, comfort, instructors, and group cohesion high/very high (4.2±0.5 to 4.8±0.3 out of 5). They also rated motivation for the videogame high (4.1±0.4 out of 5). Instructor-adolescent interactions related to building T1D management skills were rated as excellent for 78% of sessions by intervention evaluators. Similarly, sharing knowledge and experiences were rated as excellent for 68% of sessions. However, adolescent-adolescent interactions were rated poorly (communication 29% excellent, peer interactions 8% excellent). The most reported barriers to participation were negative mood and oversleeping. No participants experienced diabetic ketoacidosis, severe hypoglycemia, or injuries during the study period. Compared to baseline, glycemic metrics appeared to decrease over time (d= -1.12, 90% CI [- 1.78, -0.48]).
Conclusions: Overall, ExerT1D facilitated excellent peer support by engaging diverse youth with T1D in an MVPA program led by role models living with T1D.