Seasonal differences in physical activity, sedentary behaviour, and sleep patterns in people with type 1 diabetes in Kuwait

The main aim of the current study was to measure physical activity, sedentary behaviors and sleep levels across the different seasons in people with type 1 diabetes in Kuwait. A prospective cross-sectional study was conducted from August 2021 to September 2022. Physical activity and sleep metrics were measured over a 7-day period with a wrist-worn accelerometer (GENEActiv). The mean daily physical activity was measured as a Euclidean Norm Minus One (ENMO) in milli gravitational units (mg). Accelerometer metrics were compared across the seasons and between the sex. A total of 784 people with type 1 diabetes participated. Mean daily physical activity was 25.2 mg (SD=7.3). Seasonal differences were seen in total daily physical activity (ENMO) (p= 0.05), inactivity (p=0.04), light activity (p=0.001), the intensity gradient (p=0.001) and sleep efficiency (p=0.02). Poorer metrics were generally seen in Spring and Summer. ENMO, moderate and vigorous physical activity, and inactivity were significantly higher in males compared to females (p≤ 0.02). Females had a longer sleeping duration (p=0.02), and higher sleep efficiency (p= 0.04) and light physical activity (p=0.01). ENMO and the intensity gradient were negatively associated with HbA1c (both p=0.01). Physical activity levels were generally low and sleep poor in people with type 1 diabetes in Kuwait and these varied by sex and season. The current data are useful to target and develop interventions to improve physical activity and glycemic control.