New Recommendations Released for Exercise in Type 1 Diabetes Patients

A new consensus statement published in the Lancet Diabetes and Endocrinology provides recommendations on safe exercise and glucose management for patients with type 1 diabetes.

While individuals with type 1 diabetes tend to be at least as inactive as the general population, several additional barriers to exercise exist in these patients, including hypoglycemia and loss of glycemic control.
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The guidelines were created by a team of 21 international experts who reviewed observational studies and clinical trials on exercise management in individuals with type 1 diabetes who exercise regularly.

They provide tables detailing variability in blood glucose responses to different forms of exercise, a decision tree for aerobic exercise appropriate for individuals with type 1 diabetes, carbohydrate requirements for aerobic exercise and hypoglycemia prevention, and adjustments to insulin and food intake for the minimization of glycemic excursions following prolonged aerobic exercise.

“A sound understanding of the physiology of different forms of exercise and the variables that can influence glycaemia during exercise and sport should underpin the implementation of safe and effective glycemic management strategies,” the researchers concluded. “In all instances, additional vigilance around glucose monitoring is needed before, during, and after the physical activity.”

They noted, however, that more studies are needed to determine how best to prevent exercise-associated hypoglycemia using insulin dose adjustments and the management of glycemia following exercise.

—Michael Potts

Reference:

Riddel MC, Gallen IW, Smart CE, et al. Exercise management in type 1 diabetes: a consensus statement [published online January 23, 2017]. Lancet Diabetes Endocrinol.  doi: http://dx.doi.org/10.1016/S2213-8587(17)30014-1.