Effects of Diactive-1–Supported Progressive Resistance Training on Body Composition in Youth With Type 1 Diabetes

IF 9.1 1区医学 Q1 GERIATRICS & GERONTOLOGY

Journal of Cachexia Sarcopenia and Muscle Pub Date : 2026-03-19 DOI:10.1002/jcsm.70257

Jacinto Muñoz-Pardeza, José Francisco López-Gil, Ignacio Hormazábal-Aguayo, Mikel Izquierdo, Cesar Agostinis-Sobrinho, Yasmin Ezzatvar, Antonio García-Hermoso

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Abstract

Background

Compared to their healthy peers, children and adolescents with type 1 diabetes are at an increased risk of adverse changes in body composition, including increased fat mass along with reductions in lean and bone mass. Although exercise has shown promise in improving body mass index in this population, the individual effects of resistance training on specific body composition parameters remain understudied. The aim of the study was to evaluate the effects of resistance training supported by the mHealth application Diactive-1 on body composition in children and adolescents with type 1 diabetes.

Methods

Sixty-two participants with type 1 diabetes (aged 8–18 years old; 48% females) participated in a 24-week randomised controlled trial and were assigned to either the usual care group (n = 32) or the exercise group (n = 30). The intervention was delivered via the Diactive-1 app, which generates progressive overload resistance training programmes tailored to real-time glycaemia and provides educational support. Body composition was assessed using anthropometry and dual-energy X-ray absorptiometry, with fat, lean and bone measurements standardised by age, sex and ethnicity. Linear mixed models were used to evaluate between-group differences in change over time under both intention-to-treat (ITT) and per-protocol (PP) approaches.

Results

At 24 weeks, in the ITT analysis, the intervention group showed greater gains in lean mass (mean difference [MD] = 0.88 kg; 95% confidence interval [CI] 0.09 to 1.66; Hedges' g = 0.568) and whole-body bone mineral content less head (MD = 32.40 g; 95% CI 6.90 to 57.89; g = 0.644) compared with those in the usual care group. No changes were observed in anthropometric measures, fat mass–related regions or standardised variables (p > 0.05). The risk of probable sarcopenia was lower in the intervention group (relative risk [RR] = 0.17; 95% CI 0.04 to 0.73; Cohen's h = 0.987) than in the usual care group. Findings were directionally consistent in the PP analysis.

Conclusions

This intervention increased bone-related outcomes and was associated with modest gains in lean mass and a lower risk of probable sarcopenia in youths with type 1 diabetes. These findings highlight the potential of the Diactive-1 app as an adjunct tool to support musculoskeletal health in youths with type 1 diabetes.

Trial Registration

ClinicalTrials.gov identifier: NCT06048757

Abstract Image

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Diactive - 1支持的进行性抗阻训练对1型糖尿病青少年身体成分的影响

与健康的同龄人相比，患有1型糖尿病的儿童和青少年在身体组成方面发生不良变化的风险更高，包括脂肪量增加，瘦骨量减少。尽管运动在改善这一人群的身体质量指数方面显示出了希望，但阻力训练对特定身体成分参数的个体影响仍有待研究。该研究的目的是评估由移动健康应用程序Diactive‐1支持的阻力训练对1型糖尿病儿童和青少年身体成分的影响。方法62名1型糖尿病患者（年龄8-18岁，48%为女性）参加了一项为期24周的随机对照试验，并被分为常规护理组（n = 32）和运动组（n = 30）。干预通过Diactive‐1应用程序提供，该应用程序生成针对实时血糖的渐进式过载阻力训练计划，并提供教育支持。使用人体测量学和双能X线吸收测量法评估身体成分，并根据年龄、性别和种族对脂肪、瘦肉和骨骼进行标准化测量。使用线性混合模型来评估在意向治疗（ITT）和每个方案（PP）方法下组间随时间变化的差异。结果在24周时，在ITT分析中，与常规护理组相比，干预组在瘦体重（平均差[MD] = 0.88 kg； 95%可信区间[CI] 0.09至1.66;Hedges' g = 0.568）和全身骨矿物质含量（MD = 32.40 g; 95% CI 6.90至57.89;g = 0.644）方面有较大的增加。在人体测量、脂肪量相关区域或标准化变量中未观察到变化（p > 0.05）。干预组发生肌少症的风险低于常规护理组（相对危险度[RR] = 0.17; 95% CI = 0.04 ~ 0.73; Cohen’s h = 0.987）。结果在PP分析中方向一致。结论：该干预增加了与骨相关的结果，并与1型糖尿病青少年瘦质量的适度增加和可能的肌肉减少症风险降低相关。这些发现强调了Diactive - 1应用程序作为支持1型糖尿病青少年肌肉骨骼健康的辅助工具的潜力。临床试验注册：ClinicalTrials.gov标识符：NCT06048757

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来源期刊

Journal of Cachexia Sarcopenia and Muscle MEDICINE, GENERAL & INTERNAL-

CiteScore

13.30

自引率

12.40%

发文量

234

审稿时长

16 weeks

期刊介绍： The Journal of Cachexia, Sarcopenia and Muscle is a peer-reviewed international journal dedicated to publishing materials related to cachexia and sarcopenia, as well as body composition and its physiological and pathophysiological changes across the lifespan and in response to various illnesses from all fields of life sciences. The journal aims to provide a reliable resource for professionals interested in related research or involved in the clinical care of affected patients, such as those suffering from AIDS, cancer, chronic heart failure, chronic lung disease, liver cirrhosis, chronic kidney failure, rheumatoid arthritis, or sepsis.