American Diabetes Association
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Physical Activity and the Development of Islet Autoimmunity and Type 1 Diabetes in 5-15 Year Old Children Followed in the TEDDY Study

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posted on 2023-05-04, 16:33 authored by Xiang Liu, Suzanne Bennett Johnson, Kristian F. Lynch, Kerry Cordan, Russell Pate, Martha D. Butterworth, Åke Lernmark, William A. Hagopian, Marian J. Rewers, Richard A. McIndoe, Jorma Toppari, Anette-G. Ziegler, Beena Akolkar, Jeffrey P. Krischer, Jimin Yang, the TEDDY Study Group


Objective: This study investigated physical activity and its association with the development of islet autoimmunity (IA) and type 1 diabetes in genetically at-risk 5-15 year old children.

Research Design and Methods: As part of the longitudinal Environmental Determinants of Diabetes in the Young (TEDDY) study, annual assessment of activity using accelerometry was conducted from age 5.  Time-to-event analyses using Cox proportional hazard models were used to assess the association between time spent in moderate-to-vigorous physical activity per day and the appearance of one or several autoantibodies and progression to type 1 diabetes in three risk groups: 1) 3869 IA negative children of whom 157 became single IA positive; 2) 302 single IA positive children of whom 73 became multiple IA positive; 3) 294 multiple IA positive children of whom 148 developed type 1 diabetes. 

Results: No significant association was found in risk group 1 or risk group 2. A significant association was seen in risk group 3 (HR = 0.920, 95% CI 0.856, 0.988 per 10 minutes, p = 0.021), particularly when GADA was the first autoantibody (HR = 0.883, 95% CI 0.783, 0.996 per 10 minutes, p=0.043).

Conclusions: More daily minutes spent in moderate-to-vigorous physical activity was associated with a reduced risk of progression to type 1 diabetes in 5-15 year old children who had developed multiple islet autoantibodies.


The TEDDY Study is funded by U01 DK63829, U01 DK63861, U01 DK63821, U01 DK63865, U01 DK63863, U01 DK63836, U01 DK63790, UC4 DK63829, UC4 DK63861, UC4 DK63821, UC4 DK63865, UC4 DK63863, UC4 DK63836, UC4 DK95300, UC4 DK100238, UC4 DK106955, UC4 DK112243, UC4 DK117483, U01 DK124166, U01 DK128847, and Contract No. HHSN267200700014C from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institute of Allergy and Infectious Diseases (NIAID), Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institute of Environmental Health Sciences (NIEHS), Centers for Disease Control and Prevention (CDC), and JDRF. This work is supported in part by the NIH/NCATS Clinical and Translational Science Awards to the University of Florida (UL1 TR000064) and the University of Colorado (UL1 TR002535). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.