Digital Exercise for Middle-Aged Adults With Type 1 Diabetes and Other Absolute Insulin Deficiency Diabetes

Inclusion Criteria:

• Diagnosis with type 1 diabetes (T1D) or other insulin deficiency diabetes (latentautoimmune disease of adulthood, diabetes secondary to pancreatitis)

• Low exercise levels

• Smartphone ownership

• English literacy

• Under regular care by a healthcare provider

• Home Broadband wireless Internet or cell phone network (≥25 mbps downloads, ≥3 mbpsuploads)

Exclusion Criteria:

• Diabetic ketoacidosis not clearly related to pump site failure in past 6 months

• >1 episode of severe hypoglycemia (altered mental and/or physical status requiringassistance from another person for recovery) in past 6 months

• A1c ≥10.0%

• Resting blood pressure >160mmHg systolic or >100 mmHg diastolic

• Myocardial infarction or angina in past 12 months

• Uncontrolled arrhythmia (e.g., Afib with RVR, new onset Afib, ventriculartachycardia, escape rhythms)

• Congestive heart failure (stage 3 or 4)

• Exercise-induced asthma (not controlled on inhalers)

• Chronic obstructive pulmonary disease (requiring home oxygen)

• Renal failure

• Pregnancy

• Cognitive impairment

• Severe retinopathy or neuropathy.

• Other chronic disease or physical disability that would influence exerciseintervention (e.g., recent spinal surgery)