Abstract
Background and Aims: Physical activity is important for cardiovascular health in both type 1 (T1D) and type 2 (T2D) diabetes. However, impact of exercise on overall glucose control is unclear and fear of hypoglycaemia can be a barrier to increased activity. We investigated the association between daily step count and glucose metrics for up to 10 weeks.Methods: We included 190 participants with T1D and 181 with T2D from the HypoMETRICS study who wore blinded FreeStyle Libre 2 and Fitbit Charge 4 devices. We used generalised estimating equations to evaluate relationships between daily step count and CGM derived glucometrics including daily mean glucose, time in ranges, and sensor detected hypoglycaemic (SDH) events, adjusting for baseline HbA1c, wear time and mean step count.Results: Participants provided a mean of 55 (SD = 15.0) valid days of data, had a mean daily step count of 7061 (SD = 3,542) and a mean daily glucose of 9.0mmol/l (SD = 1.8). Every 1000 increase in steps per day was associated with a change in mean glucose of ‐0.03mmol/l in T1D and ‐0.02mmol/l in T2D (both p < 0.001), a change in time >10mmol/l of ‐0.33% in T1D and ‐0.28% in T2D (both p < 0.001), a change in time in range (3.9‐10 mmol/l) of 0.31% in T1D and 0.30% in T2D (both p < 0.001), and a 0.01 change in the number of SDH events per day (<3.9mmol/l) for T1D participants only (p = 0.02).Conclusions: Greater daily step count had a weak association with improved glucose metrics within individuals over 10 weeks of monitoring.