O-62: Assessment of exercise management competencies in adolescents with type 1 diabetes: clinical application DIACTIV
D Montt-Blanchard, F Grob, F Riera, Y Zapata, M J Maturana, M JofréAbstract
Introduction
Adolescents with T1D face complex exercise barriers, including psychosocial stigma, device-related concerns, and limited self-management autonomy, among others. Because of limited time, clinical encounters rarely assess competencies in exercise management. DIACTIV is an empathy-driven card-based tool co-designed with adolescents to facilitate structured dialogue around physical activity and diabetes management.
Objectives
To validate the DIACTIV framework by evaluating exercise management competencies, their association with physical activity levels, and their relationship with glycemic outcomes in adolescents with T1D.
Methods
Mixed methods observational study at a tertiary pediatric diabetes center in Chile. Participants selected and discussed one of 36 DIACTIV scenario cards. Competencies were scored with an expert-validated rubric across four dimensions: Strategy Comprehension, Anticipation and Prevention, Emergency Management, and Reflection and Adjustment. Physical activity and glycemic metrics (HbA1c, TIR) were collected from clinical records and IPAQ questionnaire.
Results
30 adolescents with T1D participated in the study. Analyses reveal a consistent pattern across exercise management competency domains. While Strategy Comprehension and Emergency Management appear relatively preserved, Anticipation and Prevention and Reflection and Adjustment consistently emerge as weaker domains, indicating limited proactive decision-making and reliance on reactive strategies. Higher Anticipation and Prevention scores are consistently associated with greater engagement in MVPA.
Conclusions
DIACTIV surfaces exercise competency gaps rarely assessed in clinical practice. The association between Anticipation scores and MVPA suggests that preparedness for glycemic challenges during exercise may support higher levels of physical activity. DIACTIV is a scalable clinical tool for identifying and assessing individual competency gaps in exercise education among adolescents with T1D.