Exercise management in type 1 diabetes: a consensus statement

Michael C Riddell; Ian W Gallen; Carmel E Smart; Craig E Taplin; Peter Adolfsson; Alistair N Lumb; Aaron Kowalski; Remi Rabasa-Lhoret; Rory J McCrimmon; Carin Hume; Francesca Annan; Paul A Fournier; Claudia Graham; Bruce Bode; Pietro Galassetti; Timothy W Jones; Iñigo San Millán; Tim Heise; Anne L Peters; Andreas Petz; Lori M Laffel

doi:10.1016/S2213-8587(17)30014-1

Exercise management in type 1 diabetes: a consensus statement

Lancet Diabetes Endocrinol. 2017 May;5(5):377-390. doi: 10.1016/S2213-8587(17)30014-1. Epub 2017 Jan 24.

Authors

Michael C Riddell¹, Ian W Gallen², Carmel E Smart³, Craig E Taplin⁴, Peter Adolfsson⁵, Alistair N Lumb⁶, Aaron Kowalski⁷, Remi Rabasa-Lhoret⁸, Rory J McCrimmon⁹, Carin Hume¹⁰, Francesca Annan¹¹, Paul A Fournier¹², Claudia Graham¹³, Bruce Bode¹⁴, Pietro Galassetti¹⁵, Timothy W Jones¹⁶, Iñigo San Millán¹⁷, Tim Heise¹⁸, Anne L Peters¹⁹, Andreas Petz²⁰, Lori M Laffel²¹

Affiliations

¹ Muscle Health Research Centre, York University, Toronto, ON, Canada. Electronic address: mriddell@yorku.ca.
² Royal Berkshire NHS Foundation Trust Centre for Diabetes and Endocrinology, Royal Berkshire Hospital, Reading, UK.
³ Hunter Medical Research Institute, School of Health Sciences, University of Newcastle, Rankin Park, NSW, Australia.
⁴ Division of Endocrinology and Diabetes, Department of Pediatrics, University of Washington, Seattle Children's Hospital, Seattle, WA, USA.
⁵ Department of Pediatrics, The Hospital of Halland, Kungsbacka, Sweden; Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
⁶ Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Oxford, UK.
⁷ Juvenile Diabetes Research Foundation, New York, NY, USA.
⁸ Department of Nutrition and Institut de Recherches Cliniques de Montréal, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.
⁹ Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Dundee, UK.
¹⁰ London Medical, London, UK.
¹¹ Children and Young People's Diabetes Service, University College London Hospitals NHS Foundation Trust, London, UK.
¹² School of Sport Science, Exercise, and Health, Perth, WA, Australia.
¹³ Dexcom Inc, San Diego, CA, USA.
¹⁴ Atlanta Diabetes Associates, Atlanta, GA, USA.
¹⁵ Department of Pediatrics, University of California Irvine, Irvine, CA, USA; AstraZeneca, Gaithersburg, MD, USA.
¹⁶ The University of Western Australia, Perth, WA, Australia; Department of Endocrinology and Diabetes, Princess Margaret Hospital for Children, Perth, WA, Australia; Telethon Kids Institute, Perth, WA, Australia.
¹⁷ Department of Physical Medicine and Rehabilitation, University of Colorado, School of Medicine, Aurora, CO, USA.
¹⁸ Profil, Neuss, Germany.
¹⁹ Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
²⁰ StubbaekSkole, Aabenraa, Denmark.
²¹ Division of Endocrinology, Boston Children's Hospital, Boston, MA, USA; Pediatric, Adolescent and Young Adult Section, Joslin Diabetes Center, Boston, MA, USA.

PMID: 28126459
DOI: 10.1016/S2213-8587(17)30014-1

Abstract

Type 1 diabetes is a challenging condition to manage for various physiological and behavioural reasons. Regular exercise is important, but management of different forms of physical activity is particularly difficult for both the individual with type 1 diabetes and the health-care provider. People with type 1 diabetes tend to be at least as inactive as the general population, with a large percentage of individuals not maintaining a healthy body mass nor achieving the minimum amount of moderate to vigorous aerobic activity per week. Regular exercise can improve health and wellbeing, and can help individuals to achieve their target lipid profile, body composition, and fitness and glycaemic goals. However, several additional barriers to exercise can exist for a person with diabetes, including fear of hypoglycaemia, loss of glycaemic control, and inadequate knowledge around exercise management. This Review provides an up-to-date consensus on exercise management for individuals with type 1 diabetes who exercise regularly, including glucose targets for safe and effective exercise, and nutritional and insulin dose adjustments to protect against exercise-related glucose excursions.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Blood Glucose
Contraindications
Diabetes Mellitus, Type 1*
Exercise / physiology*
Humans
Nutritional Requirements

Substances

Blood Glucose