29th Mar 2024

Background: A healthy active lifestyle (i.e. regular physical activity (PA), limited sedentary behavior (SB) and adequate sleep duration) is an important but challenging part of type 1 diabetes (T1D) management.
Aims: This systematic review aimed to summarize knowledge on explanatory variables of PA, SB and sleep in adults with T1D which is the first step toward developing interventions to achieve a healthy lifestyle.
Methods: A systematic search of four databases (PubMed, Web of Science, Scopus and Embase) was performed. Only objective measurements of PA, SB and sleep were included and all explanatory variables were classified according to the socio-ecological model (i.e. intrapersonal, interpersonal, environmental and policy level). Risk of bias (Joanna Briggs Institute appraisal checklists) and level of evidence (Evidence-Base Guideline Development) were assessed.
Results: All but one studied explanatory variables were situated at the intrapersonal level. A favorable body composition was associated with more time spent in total PA and moderate to vigorous PA (MVPA). Men with T1D spent more time in MVPA than women and a younger age was associated with increased MVPA. Barriers for PA showed an indeterminate association with MVPA.
Conclusion: This review underscores the focus on the individual level to identify explanatory variables of 24h-MBs in adults with T1D, despite the necessity for a socio-ecological approach to develop effective interventions. Based on the investigated variables, future interventions may be tailored to sex and age. More evidence on psychological, interpersonal and environmental variables is needed as these variables are (more) modifiable than health-related and socio-demographic variables.

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