An Innovative Telemedical Support System to Measure Physical Activity in Children and Adolescents with Type 1 Diabetes Mellitus

To assess physical activity in patients with type 1 diabetes an innovative telemedical support system has been developed. The aim of the feasibility trial was to prove its use in a clinical setting. Patients/methods: 16 children/adolescents with type 1 diabetes mellitus aged 14.5 +/- 2.2 years (diabetes duration 6.5 +/- 3.6 years, HbA1c 8.8 +/- 1.0%) were included in the study. During a period of 1-3 days all the patients received a telemedical assessment system. It consists of a sensor for physical activity integrated into a mobile phone (DiaTrace). Additionally it is combined with a system for continuous blood glucose monitoring (CGM). Results: The technical system was highly accepted by all the 16 children and adolescents. Physical activity measured was 13.3 +/- 5.5 AU/d, mean duration of total physical activity was 204.9 +/- 66.5 min/d (walking 102.5 +/- 62.5, running 7.4 +/- 5.8, cycling 39.2 +/- 32.7, driving 36.0 +/- 18.6, non-specific physical activity 57.0 +/- 29.7 min/d). Periods without activity lasted for 386.5 +/- 187.2 min/d. Daily energy expenditure was 1964.1 +/- 185.5 kcal/d. Correlations between physical activity (measured with DiaTrace) and blood glucose profiles (measured with CGM) were calculated. Pearson's correlation coefficients ranged between 0.59 and 0.99 (median 0.91). Hence, these good correlation coefficients show the high and direct association between blood glucose values and activity units. The wide ranges in correlation coefficients demonstrate a huge variability of individualized reactions. Conclusions: Use of innovative electronic health technology is highly accepted by patients. It reveals an accurate, real-time assessment of an individual's physical activity. These information can use for insulin dose-adjustment.