Background: The present study objectively assessed physical activity (PA) levels and patterns in children and adolescents with type 1 diabetes and compared the metabolic and physiologic health profiles of those achieving and those not achieving the current recommendation of 60 minutes a day (minutes.D-1) of at least moderate intensity PA. Method: 37 children and adolescents (20 boys, 17 girls) aged 12.7 ± 2.1 years (mean ± SD), disease duration 5.9 ± 3.0 years participated. PA was assessed using heart rate monitoring. Peak VO2 , BMI, sum of 5 skinfolds, HbA1c and daily insulin dosage were also determined. Results: Mean accumulated time in moderate-to-vigorous intensity PA was 53.6 ± 31.4 minutes.D-1. Levels of vigorous-intensity PA were low, mean 8.3 ± 10.2 minutes.D-1. When controlling for age, no differences in metabolic or physiologic health outcomes were evident between those individuals achieving, and those not achieving, 60minutes.D-1 of moderate-to-vigorous intensity PA. PA predominantly occurred in short bouts lasting 5 minutes or less. Conclusion: The efficacy of accumulating 60 minutes.D-1 of moderate-to-vigorous intensity PA, in the form of short duration, intermittent bouts of largely unplanned PA, to promote health gains in children and adolescents with type 1 diabetes is questionable.