Association of Physical Activity and Socioeconomic Status With Glycaemic Control in Adults With Type 1 Diabetes: A Cross‐Sectional Study Using CGM Data

AIMS: This study examined the independent and combined effects of physical activity and socioeconomic status (SES) on glycaemic control in adults with T1D using continuous glucose monitoring (CGM). METHODS: A cross-sectional study included 423 adults with T1D from a public healthcare setting in whom physical activity was self-assessed via the short-form International Physical Activity Questionnaire (IPAQ). SES was estimated using mean annual net income by census tract. Glycaemic outcomes included time in range (TIR) and time in tight range (TITR), derived from CGM, and HbA1c. Multivariable linear models and four-way mediation analyses were conducted. RESULTS: Higher physical activity and income were independently associated with better glycaemic control. The highest activity quartile was associated with +8.0% TIR and -0.47% HbA1c (p < 0.01). Physical activity partially mediated the effect of income on TIR (pure indirect effect β = 2.42, p = 0.013), accounting for 23% of the total effect. No significant SES-activity interaction was observed. Physically active individuals also had a 16% lower insulin requirement and better lipid profile, independent of income. A modest TBR increase occurred without longer hypoglycaemia. CONCLUSION: Physical activity is associated with improved glycaemic and lipid control in T1D patients, regardless of income. Promoting physical activity might reduce SES-related glycaemic disparities and improve outcomes.