Abstract P345: Physical Activity and Cardiorespiratory Fitness Among Adolescents With Type 1 and Type 2 Diabetes: A Systemic Review and Meta-Analysis
Bibliographic record
Abstract
Background: Physical activity (PA) is a cornerstone in the management of pediatric diabetes, due in part to a dose-response effect on cardiorespiratory fitness (CRF). The extent to which PA and CRF is impaired in children and adolescents with diabetes remains unclear. Hypothesis: We hypothesized that PA and CRF would be lower in children and adolescents with type 1 (T1D) and (T2D) compared to controls. Design and Methods: To test this hypothesis we conducted a systematic review of observational studies in MEDLINE, Embase, the Cochrane Library, and CINAHL from 2000 to April 2022. Cross sectional studies that reported PA and/or CRF for children and adolescents (0-21 years) with T1D, T2D and controls without diabetes were included in the analysis. We excluded studies in adults and those that did not differentiate diabetes type. The main outcomes of interest were objective or subjective measures of PA and direct or indirect measures of CRF. Co-variates extracted from each manuscript included body mass index, sex, measures of socio-economic status, age and ethnicity. A modified risk of bias tool was used to assess the methodological quality of each study. (Prospero registration: CRD42022329303). We used an inverse variance weighted meta-analysis to estimate effect size and precision effects. A random effects model was used. Results: Of 7857 citations retrieved, we included 42 studies with T1D (n=4027 with T1D, n=9699 controls) and 14 studies with T2D (n=581 with T2D, n=1008 controls). 26 and 2 studies included direct and indirect measures of cardiorespiratory fitness respectively. 14 and 26 studies include objective and subjective measures of PA respectively. The standardized mean difference (SMD) was PA [-0.28; 95% CI: -0.46, -0.10; I 2 = 89%] and CRF [-0.30; 95% CI: -0.66, 0.06; I 2 = 92%] were lower children and adolescents with for T1D compared to controls. The SMD for PA [-0.61; 95% CI: -0.98, -0.24; I 2 = 89%] and CRF [-1.20; 95% CI: -1.73, -0.67; I 2 = 91%] were also lower for children and adolescents with T2D compared to controls. The majority of studies were considered a high risk of bias. Conclusions: Children and adolescents with T1D display modestly lower daily PA and CRF compared to controls. Deficits in PA and CRF are more profound among children and adolescents with T2D.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.012 | 0.035 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.020 | 0.031 |
| Bibliometrics | 0.010 | 0.012 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.007 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".