31-LB: Limited Physical Activity among Overweight and Obese Young Adults with Type 1 Diabetes: Results from Advancing Care for Type 1 Diabetes and Obesity Network (ACT1ON)

This pilot and feasibility study aimed to identify dietary strategies to optimize glycemic control and weight management in overweight or obese young adults with T1D. In a sequential multiple assignment randomized trial, participants were randomized to a hypocaloric low-carbohydrate (CHO; 20-25% CHO), hypocaloric moderately low fat (30% energy fat), or Mediterranean (not calorie restricted) diet, with advice to maintain usual physical activity (PA). PA data were collected in a convenience sample of participants from 06/20 to 02/21. Young adults with T1D (n=27, age 25±3 years, 78% female, A1c 7.3±1.2%, BMI 30.7±3.4) wore PA trackers for 2-week periods during diet assignments. Median (IQR) daily steps were 4,931 (3,443-7,363), 5,562 (4,191-9,931), 6,457 (4,394-9,655) for Low CHO, Look AHEAD, and Mediterranean diets, respectively and daily moderate-to-vigorous PA (MVPA) mins were 16 (4-31), 18 (5-31), and 22 (6-32), respectively. Daily steps, active time, or MVPA did not differ by diet (p>0.05). We demonstrate that in a pilot study emphasizing diet and weight loss in young adults with T1D, PA was often below the recommended target of 30 mins MVPA/day (or 150 mins/week). Thus, a larger, adaptive weight management intervention will need to incorporate diet as well as safe and effective PA strategies for overweight and obese young adults with T1D. Disclosure D. P. Zaharieva: None. D. M. Maahs: Advisory Panel; Self; Abbott Diabetes, Dompe, Eli Lilly and Company, Medtronic, Novo Nordisk, Consultant; Self; aditxt. For the act1on study: n/a. F. R. Muntis: None. N. Arrizon- ruiz: None. J. Thomas: None. E. J. Mayer-davis: None. A. Addala: None. M. A. Clements: Consultant; Self; Eli Lilly and Company, Employee; Self; Glooko, Inc., Research Support; Self; Abbott Diabetes, Dexcom, Inc. A. Kollu: None. M. Riddell: Advisory Panel; Self; Zealand Pharma A/S, Consultant; Self; Lilly Diabetes, Research Support; Self; Dexcom, Inc., Insulet Corporation, Speaker’s Bureau; Self; Novo Nordisk Inc., Sanofi, Stock/Shareholder; Self; Zucara Therapeutics Inc. Funding National Institute of Diabetes and Digestive and Kidney Diseases (1DP3DK113358)