Supplementary Material for: Physical Activity in Very Young Children living with Type 1 diabetes

Introduction: Physical activity has health benefits for people living with type 1 diabetes (T1D), however there are barriers limiting their ability to meet minimum recommended levels of moderate-to-vigorous-physical-activity (MVPA). We aimed to measure physical activity levels and barriers to physical activity in children < 7 years of age living with T1D and compare to general population data and guidelines. Methods: Children < 7 years of age with T1D were recruited from two paediatric diabetes centres in Australia. Physical activity was measured for 7 days using an accelerometer. Parents completed questionnaires related to barriers to physical activity [Barriers to Physical Activity in Diabetes (BAPAD1) and fear of hypoglycaemia [Hypoglycemia Fear Survey - Parents of Young Children (HFS-PYC)]. Continuous Glucose Monitor (CGM) data was collected. MVPA was compared to the general population. Results: Thirty-three children, mean age 4.5 years (SD 1.2), mean HbA1c 7.1% (SD 1.1) [55 mmol/mol (SD 13)] and mean diabetes duration 35 months (SD 21) participated. Mean MVPA did not meet recommendations, although it was not significantly different to general population data [42.6 minutes (SD 26.02) v 42.8 minutes (SD 17.05), p=0.972. CGM Time in range 3.9-10mmol/L (TIR) correlated with MVPA (TauB=0.396, p=0.19). The median (Q1,Q3) for BAPAD1 average score was 2.4 (2, 4) and median HFS behaviour and worry sub-scores were both low at 2.3 (2,3). Conclusions: Children < 7 years of age did not meet the recommended daily MVPA level independent of diabetes. Parental concern regarding diabetes related barriers to physical activity was not high.