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App-supported resistance training linked to lean mass and bone gains in youth with type 1 diabetesApp-guided resistance training linked to muscle and bone gains in youth with type 1 diabetes

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Key Takeaway
Consider app-supported resistance training as a potential adjunct for musculoskeletal health in youth with T1D, pending safety data.

This 24-week randomized controlled trial evaluated a progressive overload resistance training program in 62 children and adolescents (aged 8-18, 48% female) with type 1 diabetes. The intervention was delivered via the Diactive-1 mHealth application, tailored to real-time glycaemia with educational support, and compared to usual care. The primary outcome was not explicitly stated.

The intervention group showed greater gains in lean mass compared to usual care, with a mean difference of 0.88 kg (95% CI 0.09 to 1.66; Hedges' g = 0.568). Greater gains were also observed for whole-body bone mineral content less head, with a mean difference of 32.40 g (95% CI 6.90 to 57.89; Hedges' g = 0.644). The intervention was associated with a lower risk of probable sarcopenia (relative risk = 0.17; 95% CI 0.04 to 0.73). No changes were observed for anthropometric measures, fat mass-related regions, or standardized variables (p > 0.05).

Safety, tolerability, adverse events, and discontinuations were not reported. Key limitations include the lack of a reported primary outcome and the absence of safety data. The study highlights the potential of the Diactive-1 app as an adjunct tool to support musculoskeletal health in this population, but the findings require confirmation in larger trials with comprehensive safety monitoring.

Researchers studied whether a smartphone app could help young people with type 1 diabetes improve their body composition. They enrolled 62 children and adolescents, aged 8 to 18, and randomly assigned them to either use the Diactive-1 app for guided resistance training or to continue with their usual care for 24 weeks. The app provided personalized exercise plans based on real-time blood sugar levels.

After six months, the group using the exercise app gained more lean muscle mass and had greater increases in bone mineral content than the usual care group. They also had a lower estimated risk of muscle loss. The study did not find changes in body weight or fat mass measures between the two groups. The researchers did not report any safety or tolerability data from the program.

This was a relatively small study that lasted about six months. While the results are promising, they show an association between using the app and these physical improvements, not proof that the app caused them. More research is needed to see if these benefits last over a longer time and to understand the program's safety. For now, the findings suggest that app-supported resistance training could be a helpful tool for supporting muscle and bone health in young people with type 1 diabetes, but it should be discussed with a healthcare provider.

What this means for you:
A small study found app-guided exercise was linked to better muscle and bone measures in youth with diabetes over 24 weeks.

Study Details

Study typeRct
EvidenceLevel 2
Follow-up5.5 mo
PublishedApr 2026
View Original Abstract ↓
BACKGROUND: Compared to their healthy peers, children and adolescents with type 1 diabetes are at an increased risk of adverse changes in body composition, including increased fat mass along with reductions in lean and bone mass. Although exercise has shown promise in improving body mass index in this population, the individual effects of resistance training on specific body composition parameters remain understudied. The aim of the study was to evaluate the effects of resistance training supported by the mHealth application Diactive-1 on body composition in children and adolescents with type 1 diabetes. METHODS: Sixty-two participants with type 1 diabetes (aged 8-18 years old; 48% females) participated in a 24-week randomised controlled trial and were assigned to either the usual care group (n = 32) or the exercise group (n = 30). The intervention was delivered via the Diactive-1 app, which generates progressive overload resistance training programmes tailored to real-time glycaemia and provides educational support. Body composition was assessed using anthropometry and dual-energy X-ray absorptiometry, with fat, lean and bone measurements standardised by age, sex and ethnicity. Linear mixed models were used to evaluate between-group differences in change over time under both intention-to-treat (ITT) and per-protocol (PP) approaches. RESULTS: At 24 weeks, in the ITT analysis, the intervention group showed greater gains in lean mass (mean difference [MD] = 0.88 kg; 95% confidence interval [CI] 0.09 to 1.66; Hedges' g = 0.568) and whole-body bone mineral content less head (MD = 32.40 g; 95% CI 6.90 to 57.89; g = 0.644) compared with those in the usual care group. No changes were observed in anthropometric measures, fat mass-related regions or standardised variables (p > 0.05). The risk of probable sarcopenia was lower in the intervention group (relative risk [RR] = 0.17; 95% CI 0.04 to 0.73; Cohen's h = 0.987) than in the usual care group. Findings were directionally consistent in the PP analysis. CONCLUSIONS: This intervention increased bone-related outcomes and was associated with modest gains in lean mass and a lower risk of probable sarcopenia in youths with type 1 diabetes. These findings highlight the potential of the Diactive-1 app as an adjunct tool to support musculoskeletal health in youths with type 1 diabetes. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT06048757.
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