Exercise in type 1 diabetes: real-world data on glucose levels and hypoglycaemia risk from over 420,000 exercise sessions
Authors' conclusion
Aerobic activities decreased glucose more during exercise sessions than anaerobic exercise and yielded larger acute hypoglycaemia risk; anaerobic activities yielded the largest 24 h glycaemic improvements. More-intense exercise resulted in a larger nocturnal hypoglycaemia than walking; exercise timing was not a relevant contributor to nocturnal hypoglycaemia.
Study context
- Population
- T1D users of mySugr Logbook and Apple Health; mean ± SD age 41.23±12.25 years, GMI 7.05±1.09%, 41.5% female428,058 exercise sessions
- Participants
- 3,248 users
- Exposure
- Walking vs aerobic vs anaerobic exercise; active vs sedentary days
- Outcome
- Change in glucose during exercise
- Follow-up
- Acute
Methodological detailslarge
- Large
Main finding
As reported in the abstract
WALK
−1.24
mean · SD 0.81 · mmol/l
AER
−1.43
mean · SD 1.02 · mmol/l
ANAER
−0.52
mean · SD 0.81 · mmol/l
- Exercise independent of type decreased glucose
- −1.06±0.89 mmol/l
Observational data: associations, not effects.
Further findings
Mean, %
| Outcome | WALK | AER | ANAER |
|---|---|---|---|
| TIR (3.9-10 mmol/l) change, active vs sedentary days · 24 h | +2.08 (SD 6.06) | +2.94 (SD 6.46) | +3.93 (SD 7.16) |
- TIR (3.9-10 mmol/l) change, active vs sedentary days: all p<0.001
Exercise after 15:30 vs earlier: nocturnal hypoglycaemia risk
- Later activities did not increase risk of nocturnal hypoglycaemia
- +0.9±0.34%; p<0.01
Safety
TBR (<3.9 mmol/l) change, active vs sedentary days · 24 h
- TBR (<3.9 mmol/l) change, active vs sedentary days: all p<0.001
Acute and nocturnal hypoglycaemia
- ANAER yielded a smaller chance of acute hypoglycaemia and WALK a smaller chance of nocturnal hypoglycaemia
- P < 0.001
Original publication
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