Exp Clin Endocrinol Diabetes 2011; 119(9): 565-568
DOI: 10.1055/s-0031-1273747
Short Communication

© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

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

R. Schiel1 , 2 , A. Thomas3 , A. Kaps1 , G. Bieber4
  • 1MEDIGREIF-Inselklinik Heringsdorf GmbH, Department of Diabetes and Metabolic Diseases, Seeheilbad Heringsdorf, Germany
  • 2Professor of Diabetes and Health Care Management, University of Applied Science, Rheine, Germany
  • 3Medtronic GmbH, Meerbusch, Germany
  • 4Fraunhofer-Institut für Graphische Datenverarbeitung (IGD), Rostock, Germany
Weitere Informationen

Publikationsverlauf

received 29.12.2010 first decision 17.02.2011

accepted 22.02.2011

Publikationsdatum:
06. April 2011 (online)

Abstract

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 1 964.1±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.

1 International patent (Deutsches Patent- und Markenamt,Berlin, Germany) No. 6324 / P, 28.05.2009

References

  • 1 Aadahl M, Kjaer M, Jorgensen T. Associations between overall physical activity level and cardiovascular risk factors in an adult population.  Eur J Epidemiol. 2007;  22 369-378
  • 2 Assah FK, Brage S, Ekelund U. et al . The association of intensity and overall level of physical activity energy expenditure with a marker of insulin resistance.  Diabetologia. 2008;  51 1399-1407
  • 3 Bieber G, Thom A. DiaTrace – Neuartiges Assistenz-System für die Gesundheitsprävention zur Nahrungsaufnahme und Bewegungserfassung.. (Abstract) Ambient Assisted Living Association, VDE Berlin, Germany; 2008: 275-280
  • 4 Byberg L, Zethelius B, McKeigue PM. et al . Changes in physical activity are associated with changes in metabolic cardiovascular risk factors.  Diabetologia. 2001;  44 2134-2139
  • 5 Dabelea D, D’Agostino RB, Mason CC. et al . Development, validation and use of an insulin sensitivity score in youths with diabetes: the SEARCH for Diabetes in Youth study.  Diabetologia. 2011;  54 78-86
  • 6 Danne T, Battelino T, Jarosz-Chobot P. et al the PedPump Study Group Establishing glycaemic control with continuous subcutaneous insulin infusion in children and adolescents with type 1 diabetes: Experience of the PedPump study in 17 countries.  Diabetologia. 2008a;  51 1594-1601
  • 7 Danne T, Lange K, Kordonouri O. Real-time glucose sensors in children and adolescents with type-1 diabetes.  Horm Res. 2008b;  70 193-202
  • 8 Golicki DT, Golicka D, Groele L. et al . Continuous glucose monitoring system in children with type 1 diabetes mellitus: A systematic review and meta-analysis.  Diabetologia. 2008;  51 233-240
  • 9 Hawley JA, Gibala MJ. Exercise intensity and insulin sensitivity: How low can you go?.  Diabetologia. 2009;  52 1709-1713
  • 10 Kaps A, Bieber G, Schiel R. Electronic health technology for assessment of physical activity and eating habits in children and adolescents with overweight and obesity.  (Abstract) Diabetologia. 2009;  52 S273-S274
  • 11 Kordonouri O, Pankowska E, Rami B. et al . Sensor-augmented pump therapy from the diagnosis of childhood type 1 diabetes: Results of the Pediatric Onset Study (ONSET) after 12 months of treatment.  Diabetologia. 2010;  53 2487-2495
  • 12 Rewers M, Pihoker C, Donaghue K. et al . ISPAD clinical practice recommendations: Assessment and monitoring of glycemic control in children and adolescents with diabetes.  Pediatr Diabetes. 2007;  8 408-418
  • 13 Schiel R, Kaps A, Bieber G. et al . Identification of determinants for weight reduction in children and adolescents with overweight and obesity.  J Telemed Telecare. 2010;  16 368-373
  • 14 Schiel R, Kaps A, Bieber G. Bei Kindern und Jugendlichen mit Typ-1-Diabetes mellitus warden körperliche Aktivität, Ruhe und die Ernährung telemedizinisch erfasst.  (Abstract) Diabetologie Stoffw. 2009;  4 S13
  • 15 Silverstein J, Klingensmith G, Copeland K. Care of children and adolescents with type 1 diabetes. A statement of the American Diabetes Association.  Diabetes Care. 2005;  28 186-212
  • 16 Wareham JN, Brage S, Franks PW. et al .Physical activity and insulin resistance.. In: Kumar S, O’Rahilly S (eds). Insulin resistance: Insulin action and its disturbances in disease Wiley, Chichester; 2005: 317-400

1 International patent (Deutsches Patent- und Markenamt,Berlin, Germany) No. 6324 / P, 28.05.2009

Correspondence

Prof. Dr. med. habil. R. Schiel

Head and Medical Director

MEDIGREIF-Inselklinik

Heringsdorf GmbH

Department of Diabetes and

Metabolic Diseases

Setheweg 11

D–17424 Seeheilbad

Heringsdorf

Germany

Telefon: +49/383/78 780 500

Fax: +49/383/78 780 555

eMail: r.schiel@medigreif-inselklinikum.de