Why is this important?
Only nearly 30% of type 1 diabetics reach 150 minutes per week of moderate to intense physical activity. Among one of the major brakes, the risk of hypoglycemia comes back regularly.
Maintaining glycemic control during and following exercise is an important issue for patients with type 1 diabetes. These data are interesting and will most likely enrich future recommendations.
Methodology
This study evaluated the impact in type 1 diabetics of exercise programs carried out at home. Adult participants were randomized to three groups (aerobic, sequential, and resistance exercise) to complete 6 exercise sessions over a 4-week period. Patients had to report exercises performed and not performed, their food intake and the doses of insulin administered using a personalized application. They also had to transmit data relating to their insulin pump for those who had one, their heart rate and their glycemic control data.
Principle results
Overall, 497 adults with T1D were included (mean age 37 ± 14 years; mean HbA1c 6.6 ± 0.8%; mean disease duration 18 ± 13 years) and randomized between a group of structured exercises of aerobic (n=162), sequenced exercise (n=165) and resistance exercise (n=170). The median time between exercise sessions was 4.0 days and the median duration of sessions was 30 minutes. Subjects were physically active for 4.3 hours (median) per week.
The mean change in blood glucose was -18 mg/dL, -14 mg/dL and -9mg/dL respectively for the structured aerobic exercise, sequenced exercise and resistance exercise group (p<0.001).
No significant difference was found between those with a standard insulin pump, a closed-loop system, and multiple daily dose users.
The average time spent in the target glycemic range (70-180 mg/dL or 3.9-10.0 mmol/L) was greater during the 24 hours immediately following exercise than on non-exercise days physical: 76% versus 70%, p<0,001).
Several factors influencing the variation in glucose levels have been highlighted, in particular gender (sessions performed by men were associated with a greater decrease in glucose levels). On the other hand, following adjustments, gender was no longer a factor influencing the variation in glucose levels. Other factors modifying the variation in the blood glucose level were observed: HbA1c on inclusion, blood glucose level on inclusion, age, heart rate, time of day during which the exercise was performed.
Compared to non-exercise days, patients had a greater drop in blood sugar and stayed within the target range longer on days when they exercised.