Associations Between Movement Behaviors and Glycemic Variability in Healthy Adolescents: A Multiday Accelerometry and Continuous Glucose Monitoring Study

PURPOSE: Glycemic variability is a potential risk factor for cardiometabolic disease. As adolescence is a critical period for establishing metabolic health, this study examined associations between daily physical activity (PA) levels, sedentary time, and glycemic variability in healthy adolescents under free-living conditions. METHODS: Eighty-seven adolescents (53 girls; mean age: 12.9 [0.8] y) wore a continuous glucose monitor (FreeStyle Libre) and an accelerometer (ActiGraph) concurrently over 8 days. Generalized estimating equations examined daily associations in participants with ≥3 days of concurrent accelerometer/continuous glucose monitor data, after adjusting for key confounders. RESULTS: Vigorous PA was consistently associated with a lower glucose coefficient of variation (exponentiated beta coefficient [exp β] = 0.898; 95% CI, 0.828-0.974; P = .010), mean amplitude of glycemic excursion (exp β = 0.889; 95% CI, 0.804-0.983; P = .022), and SD of glucose (exp β = 0.914; 95% CI, 0.845-0.988; P = .023) and a greater percentage in the 3.9 to 7.8 mmol·L-1 glucose range (exp β = 1.020; 95% CI, 1.003-1.038; P = .019). Moderate-to-vigorous PA was also inversely associated with coefficient of variation and SD of glucose (P ≤ .018). Yet, sedentary time, light PA, moderate PA, and total PA were not significantly associated with any glycemic metric (P ≥ .145). CONCLUSION: PA at moderate-to-vigorous, and especially vigorous, intensities was associated with lower glycemic variability in healthy adolescents.