Diabetes and Obesity in Youth: Parent and Teen Perspectives on a Personalized Exercise Program

Tuesday, 14 July 2009: 1:45 PM

Melissa Spezia Faulkner, RN, DSN, FAAN
Sara Michaliszyn, PhD
Omar Contreras, BS
Kimberly Romney, BS
College of Nursing/University of Arizona, Tucson, AZ

Learning Objective 1: 1. Describe current recommendations for physical activity in adolescents.

Learning Objective 2: 2. Describe the physical activity measurement capabilities with accelerometry.

Purpose: Childhood diabetes is a growing epidemic worldwide. Youth with type 1 (T1DM) or type 2 diabetes (T2DM), or who are obese, require physically active lifestyles to maintain glucose control or prevent insulin resistance. This study aimed to determine the feasibility of conducting a 16-week personalized exercise program (PEP) based upon individual fitness levels (V02 peak)  for teens with T1DM, T2DM, or who were obese (BMI > 95th percentile).

Methods: Mixed methods were used to examine adherence to PEP and to obtain feedback from interviews with parents and teens. Teens were to wear the MTI Actigraph ® accelerometer while awake 5 days/week during PEP. At least 10 hours/day of accelerometer data were required for the analysis. Results: Twenty teens participated (13 T1DM, 2 T2 DM, 5 obese): 11 Hispanics, 9 Non-Hispanics; 14 males, 6 females. Mean age was 14.3 ± 1.6 yrs. Mean A1c levels were 9.1 ± 1.9 (T1DM) vs. 7.2 ± 0.7% (T2DM). Mean duration of moderate to vigorous physical activity (MVPA)/day was 58.9 ± 26.7 minutes, the mean intensity level was 3.9 ± 0.4 metabolic equivalents (METS), and the frequency of attaining 60 minutes of MVPA was 33.1 ± 27.5 % . There were no significant differences in adherence among groups. A limitation is that the teens wore the accelerometer the required 10 hours/day an average of 56 ± 30 days. Themes in interviews were gaining responsibility to exercise, improving glucose control, needing flexibility in routines, and disliking wearing the accelerometer. Conclusion: This is the first study to explore the use of accelerometers to measure longitudinal exercise adherence. Teens achieved moderate levels of activity close to the recommended duration of 1 hr/day, but not at the recommended frequency of 5 days/week. Further study is needed to develop and test strategies to promote exercise and measure adherence in this population.