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The Athlete with Type 1 Diabetes: Transition from Case Reports to General Therapy Recommendations

Authors Yardley JE

Received 17 October 2019

Accepted for publication 27 November 2019

Published 6 December 2019 Volume 2019:10 Pages 199—207


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Prof. Dr. Andreas Imhoff

Jane E Yardley1–4

1Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada; 2Alberta Diabetes Institute, Edmonton, Canada; 3Augustana Faculty, University of Alberta, Camrose, Canada; 4Women’s and Children’s Research Institute, Edmonton, Canada

Correspondence: Jane E Yardley
Augustana Faculty, University of Alberta, 4901 – 46th Avenue, Camrose, AB T4V 2R3, Canada
Tel +1 780 679 1688
Fax +1 780 679 1590

Abstract: Fear of hypoglycemia is a common barrier to exercise and physical activity for individuals with type 1 diabetes. While some of the earliest studies in this area involved only one or two participants, the link between exercise, exogenous insulin, and hypoglycemia was already clear, with the only suggested management strategies being to decrease insulin dosage and/or consume carbohydrates before and after exercise. Over the past 50 years, a great deal of knowledge has been developed around the impact of different types and intensities of exercise on blood glucose levels in this population. Recent decades have also seen the development of technologies such as continuous glucose monitors, faster-acting insulins and commercially available insulin pumps to allow for the real-time observation of interstitial glucose levels, and more precise adjustments to insulin dosage before, during and after activity. As such, there are now evidence-based exercise and physical activity guidelines for individuals with type 1 diabetes. While the risk of hypoglycemia has not been completely eliminated, therapy recommendations have evolved considerably. This review discusses the evolution of the knowledge and the technology related to type 1 diabetes and exercise that have allowed this evolution to take place.

Keywords: exercise, physical activity, blood glucose, insulin, carbohydrate, continuous glucose monitoring

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