2788-LB: Association between Daily Depressed Mood, Physical Activity, and Glucose Time in Range in Young Adults with Youth-Onset Type 1 Diabetes

Introduction and Objective: ADA recommends ≥150 minutes/week of moderate to vigorous physical activity (MVPA) for young adults with type 1 diabetes (T1D); however, ~ 70% fail to meet these guidelines. Prior studies demonstrated associations between PA, depression, and glycemic outcomes at the between-person level; however, less is known about how daily fluctuations in these factors relate to day-to-day time in range (TIR). We explored whether same day or subsequent variation in depression and MVPA predicts TIR. Methods: We analyzed 14 days of intensive longitudinal data from the ongoing SEARCH Food Security Cohort Study 2 among 121 young adults (18−41 years) with T1D. Sad mood was assessed daily using a single-item measure “How depressed/sad are you right now?” on a 0−7 scale with higher scores indicating greater sadness. Daily MVPA was actigraphy-derived, while TIR based on continuous glucose monitoring (% between 70−180 mg/dL). We applied linear mixed effect models including same day and lagged (prior day) effects, adjusting for diabetes duration, demographic, socioeconomic, clinical, and behavioral covariates. Results: Between participants, neither sad mood (β = −1.56, p = 0.61) nor MVPA (β = 3.00, p = .47) were associated with TIR. However, an additional hour of MVPA per day was positively associated on the same day with a 0.24%-point increase in TIR (β = 0.24, p < .001). In models that considered a lagged effect, each additional hour of MVPA was associated with a 0.92%-point increase in TIR (β = 0.92, p < .001) 1 day later, a 0.87%-point increase 2 days later (β = 0.87, p < .001), a 0.58%-point increase 3 days later (β = 0.78, p = .005), and a 0.53%-point increase 4 days later (β = 0.53, p = .023). Conclusion: Increasing time spent in MVPA was associated with immediate improvements in TIR, with significant associations persisting for up to 4 subsequent days. These findings suggest that the glycemic benefits of MVPA may extend beyond the day it is performed, highlighting a promising target for interventions to improve daily TIR. Disclosure A.M. Alfalki: None. E.F. Julceus: None. K. Flory: None. T. Bekelman: None. E. Cobry: None. A. Mclain: None. M. Lohman: None. J.A. Mendoza: None. F. Malik: None. J. Yang: None. C. Di: None. A.D. Liese: None. Funding National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases (R01DK117461), and National Institute of General Medical Sciences (T32-GM081740)