OBJECTIVE: To evaluate the effects of resistance training supported by the mobile health application Diactive-1 on the daily insulin dose and glycemic parameters in children and adolescents with type 1 diabetes. RESEARCH DESIGN AND METHODS: In this 24-week randomized clinical trial, Diactive-1 generated progressive overload resistance training sessions tailored to real-time glycemia and provided educational support. Insulin and glycemic parameters were collected from LibreView or CareLink, whereas glycosylated hemoglobin (HbA1c) was extracted from medical records. Muscular strength was assessed using a handgrip dynamometer and e-GYM machines, targeting pushing, pulling, and lower-limb movements. The effect was analyzed using linear mixed models. RESULTS: Sixty-two participants (age 8 to 18 years, girls: 48%) with type 1 diabetes (HbA1c: 7.6% (60.4 mmol/mol)) were allocated to the usual care (n = 32) or the Diactive-1 group (n = 30). Daily insulin dose reductions were observed within the Diactive-1 group (mean difference (MD) -0.10 units/kg, 95% CI -0.18 to -0.01) and when compared with usual care (MD -0.17 units/kg, 95% CI -0.26 to -0.07). No adverse effects were observed on the glycemic risk index or the incidence of hypoglycemic events. Finally, handgrip strength (MD 2.90 kg, 95% CI 1.57 to 4.22), one-repetition maximum strength (MD 1.34, 95% CI 0.21 to 2.46), and muscular power (MD 0.97, 95% CI 0.01 to 1.93) increased. Four participants (6.5%) withdrew from the study. CONCLUSIONS: Diactive-1 appears to be a safe and feasible adjunct to standard care in children and adolescents with type 1 diabetes. Its resistance training component effectively reduced insulin requirements and improved muscular strength, without increasing the risk of adverse glycemic events.
Copyright American Diabetes Association. Reprinted with permission from The American Diabetes Association.

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