title: An innovative telemedical support system to measure physical activity in children and adolescents with type 1 diabetes mellitus.
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.
  
  
  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.
authors.affiliation: MEDIGREIF-Inselklinik Heringsdorf GmbH, Department of Diabetes and Metabolic Diseases, Seeheilbad Heringsdorf, Germany. r.schiel@medigreifinselklinikum.de
authors.forename: R
authors.initials: R
authors.lastname: Schiel
authors.forename: A
authors.initials: A
authors.lastname: Thomas
authors.forename: A
authors.initials: A
authors.lastname: Kaps
authors.forename: G
authors.initials: G
authors.lastname: Bieber
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D000465:Algorithms; D001786:Blood Glucose / Q000032:analysis; D040421:Cell Phone; D002648:Child; D002652:Child Behavior / Q000523:psychology; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000523:psychology / Q000628:therapy*; D004734:Energy Metabolism; D005240:Feasibility Studies; D005260:Female; D005858:Germany; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D018670:Monitoring, Ambulatory / Q000379:methods*; D009043:Motor Activity; D010342:Patient Acceptance of Health Care; D017216:Telemedicine / Q000379:methods*
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human