Education and individualized support regarding exercise and diabetes improves glucose control and level of physical activity in type 1 diabetes individuals (original) (raw)
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Exercise management in type 1 diabetes: a consensus statement
The lancet. Diabetes & endocrinology, 2017
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 ...
Techniques for Exercise Preparation and Management in Adults with Type 1 Diabetes
Canadian Journal of Diabetes, 2016
People with type 1 diabetes are at risk for early-and late-onset hypoglycemia following exercise. Reducing this risk may be possible with strategic modifications in carbohydrate intake and insulin use. We examined the exercise preparations and management techniques used by individuals with type 1 diabetes before and after physical activity and sought to determine whether use of differing diabetes technologies affects these health-related behaviours. Methods: We studied 502 adults from the Type 1 Diabetes Exchange's online patient community, Glu, who had completed an online survey focused on diabetes self-management and exercise. Results: Many respondents reported increasing carbohydrate intake before (79%) and after (66%) exercise as well as decreasing their meal boluses before (53%) and after (46%) exercise. Most reported adhering to a target glucose level before starting exercise (77%). Despite these accommodations, the majority reported low blood glucose (BG) levels after exercise (70%). The majority of users of both insulin pump therapy (CSII) and continuous glucose monitoring (CGM) (Combined) reported reducing basal insulin around exercise (55%), with fewer participants adjusting basal insulin when using other devices (SMBG only = 20%; CGM = 34%; CSII = 42%; p<0.001). However, CSII and Combined users reported that exercise makes their BG levels harder to control (p<0.05) and makes them feel less able to predict their BG levels while exercising (p<0.001); they show agreement that fear of low BG levels keeps them from exercising (p<0.01). Conclusions: These findings highlight the need for exercise-management strategies tailored to individuals' overall diabetes management, for despite making exercise-specific adjustments for care, many people with type 1 diabetes still report significant difficulties with BG control when it comes to exercise.
Review Exercise management in type 1 diabetes: a consensus statement
Type 1 diabetes is a challenging condition to manage for various physiological and behavioural reasons. Regular exercise is important, but management of diff erent forms of physical activity is particularly diffi cult 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 profi le, body composition, and fi tness 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 eff ective exercise, and nutritional and insulin dose adjustments to protect against exercise-related glucose excursions.
Objective: Maintenance of glycemic control during and following exercise remains a major challenge for individuals with type 1 diabetes. Glycemic responses to exercise may differ by exercise type (aerobic, interval, resistance), and the effect of activity type on glycemic control following exercise remains unclear. Research Design-Methods: The Type 1 Diabetes Exercise Initiative (T1Dexi) was a real-world study of at-home exercise. Adult participants were randomly assigned to complete six structured aerobic, interval, or resistance exercise sessions over 4-weeks. Participants self-reported study and non-study exercise, food intake, and insulin dosing (multiple-daily injection [MDI] users) using a custom smart phone application, and provided pump data (pump users), heart rate, and continuous glucose monitoring (CGM) data. Results: 497 adults with type 1 diabetes, mean±SD age 37±14 years, HbA1c 6.6±0.8% (49±8.7 mmol/mol) assigned to structured aerobic (N=162), interval (N=165), or r...
Diabetes Care
OBJECTIVEMaintenance of glycemic control during and after exercise remains a major challenge for individuals with type 1 diabetes. Glycemic responses to exercise may differ by exercise type (aerobic, interval, or resistance), and the effect of activity type on glycemic control after exercise remains unclear.RESEARCH DESIGN AND METHODSThe Type 1 Diabetes Exercise Initiative (T1DEXI) was a real-world study of at-home exercise. Adult participants were randomly assigned to complete six structured aerobic, interval, or resistance exercise sessions over 4 weeks. Participants self-reported study and nonstudy exercise, food intake, and insulin dosing (multiple daily injection [MDI] users) using a custom smart phone application and provided pump (pump users), heart rate, and continuous glucose monitoring data.RESULTSA total of 497 adults with type 1 diabetes (mean age ± SD 37 ± 14 years; mean HbA1c ± SD 6.6 ± 0.8% [49 ± 8.7 mmol/mol]) assigned to structured aerobic (n = 162), interval (n = 1...
Approach of Physical Activity in Type 1 Diabetic Patients
Medicus
Type 1 Diabetes Mellitus (T1DM) is an autoimmune disease caused by an absolute deficiency of insulin because of the destruction of β cells islet of the pancreas. Aerobic exercise and diet are the two main points of diabetes treatment. Methods: The data for this study comes from un online survey of 50 people with health diseases, conducted between June 8 and July 12, 2021. More precisely, the data of our study are un mail-only data, with people selected randomly from a database maintained by B-Sport Plus Project. The database contains questions about physical activities in diabetic patients. Results: Among the 50 interviewers with type 1 diabetes, the largest age group covers those younger than 18 years old. 31% of the patients answered that health conditions limit their daily activity. 47% of them spent 1-2 h on sport and recreational activity per day. 47% of the patients reported they do multiple sport activities, the others do leisurely walking (walking their dog), bicycling, skat...
What are the health benefits of physical activity in type 1 diabetes mellitus? A literature review
Diabetologia, 2012
Physical activity improves well-being and reduces the risk of heart disease, cancer and type 2 diabetes mellitus in the general population. In individuals with established type 2 diabetes, physical activity improves glucose and lipid levels, reduces weight and improves insulin resistance. In type 1 diabetes mellitus, however, the benefits of physical activity are less clear. There is poor evidence for a beneficial effect of physical activity on glycaemic control and microvascular complications, and significant risk of harm through hypoglycaemia. Here we review the literature relating to physical activity and health in type 1 diabetes. We examine its effect on a number of outcomes, including glycaemic control, lipids, blood pressure, diabetic complications, well-being and overall mortality. We conclude that whilst there is sufficient evidence to recommend physical activity in the management of type 1 diabetes, it is still unclear as to what form, duration and intensity should be recommended and whether there is benefit for many of the outcomes examined. Keywords Complications . Glycaemic control . HbA 1c . Physical activity . Review . Type 1 diabetes Abbreviations CVD Cardiovascular disease BMD Bone mineral density Á V O 2max Maximal aerobic capacity Diabetologia (2012) 55:542-551
A pilot program for physical exercise promotion in adults with type 1 diabetes: the PEP-1 program
Applied Physiology, Nutrition, and Metabolism, 2014
Physical inactivity is highly common in adults with type 1 diabetes (T1D) as specific barriers (i.e., hypoglycemia) may prevent them from being active. The objective of this study was to examine the efficacy of the Physical Exercise Promotion program in type 1 diabetes (PEP-1) program, a group program of physical activity (PA) promotion (intervention) compared with an information leaflet (control), to improve total energy expenditure (TEE) in adults with T1D after 12 weeks. TEE was measured with a motion sensor over a 7-day period at inclusion, after the program (12 weeks) and 1-year after inclusion. The 12 weekly sessions of the program included a 30-min information session (glycemic control and PA) and 60 min of PA. A total of 48 adults, aged 18 to 65 years with a reported PA practice <150 min per week, were recruited (45.8% men; aged 44.6 ± 13.3 years; 8.0% ± 1.1% glycated hemoglobin (A1c)) and randomized in this pilot trial. Ninety percent of participants completed the program and 88% completed the 1-year follow-up. No change was observed for TEE and A1c in both groups. After the 12-week program, the mean peak oxygen uptake increased (14%; p = 0.003) in the intervention group; however, at the 1-year follow-up, it was no longer different from baseline. In the control group, no difference was observed for the peak oxygen uptake. These results suggest that the PEP-1 pilot program could increase cardiorespiratory fitness. However, this benefit is not sustained over a long-term period. The PEP-1 program did not increase TEE in patients with T1D and other strategies remain necessary to counteract physical inactivity in this population.
Glycemic patterns related to exercise in type 1 diabetes
2014
How to Assist Patients to use an Insulin Pump Safely and Effectively and to Stay on the Device People with diabetes wish to be able to self-manage their diabetes in order to achieve biomedical outcomes within target and they also desire to have the burden of self-management reduced to the extent that their quality of life is improved. Insulin Pump therapy can assist, but this is not always the case. A certain approach needs to be in place in order to ensure that Insulin Pump therapy is not just another treatment given to patients with an expectation that they will both master it and achieve improved outcomes. Education is the key to ensuring improvements in biomedical outcomes, in self-management and in burden reduction. And not just any education programme-structured education that is underpinned by facets that lead to mastery and maintenance is required. Health Care Professionals (HCPs) are accustomed to providing education that includes knowledge and self-management skills, however HCPs are beginning to recognise that these alone are not enough. If the twin goals of selfmanagement and reduced burden are to be achieved then the structured education also needs to incorporate ways to improve confidence, participation in goal setting and decision making, coping skills, and self-efficacy. Insulin pump pathway Choice of pump Trial using saline Education-bite-sized chunks Availability of HCPs and Pump Expertise We will examine the attributes above to establish how the knowledge and skills needed for Insulin Pump therapy can be best presented by HCPs.