The association of device based-physical activity and sleep metrics with depression in people with type 1 diabetes in Kuwait: a cross sectional study (Preprint)

BACKGROUND People with diabetes and depression have worse health outcomes and may be protected by physical activity, but the relationship between activity and depression is not studied in people with type 1 diabetes. OBJECTIVE The aim of this study was to investigate the association of physical activity and sleep metrics, measured via wrist-worn accelerometers, with depression in people with type 1 diabetes in Kuwait. METHODS People with type 1 diabetes were recruited from the Dasman Diabetes Institute in Kuwait and were invited to wear a wrist worn accelerometer device for 7 days. Mean physical activity (overall acceleration), inactivity, light activity, moderate activity, vigorous activity, the distribution of physical activity intensity (intensity gradient), sleep duration and sleep efficiency were quantified from the accelerometer data. The associations of these metrics with depression were investigated using multiple linear regression. RESULTS A total of 551 people (52.5% women) people with type 1 diabetes (age 33.1 (9.5) years) were included. Overall physical activity (B= -0.09, CI= -0.14 to – 0.04), moderate intensity activity (B= -0.02, CI= -0.02 to -0.01), vigorous intensity activity (B= -0.16, CI= -0.27 to -0.05), and the intensity gradient (B= -2.11, CI= -3.51 to -0.72) were negatively associated with depression score (P CONCLUSIONS Overall, moderate and vigorous physical activity, and the intensity gradient, but not inactivity, light physical activity or sleep, were associated with depression. Overall physical activity, rather than the distribution of activity intensity, appears more important in depression. This information can help guide physical activity interventions to improve depression in people with type 1 diabetes in Kuwait.