Hypoglycemia incidence and behavioural adjustments during free‐living unstructured physical activity in adults with type 1 diabetes using automated insulin delivery (AID) systems: Results from the RAPPID study
Authors' conclusion
Hypoglycemia remains common during and after PA in AID users. Suboptimal adjustment strategies and impaired symptom awareness contribute to risk. Individualised education remains essential to enhance safety.
Study context
- Population
- Adults with T1D using one of three AID systems (MiniMed 780G, Tandem t:slim X2 with Control-IQ, or Ypsopump with CamAPS FX) performing ≥2 unstructured physical activity (PA) sessions/week, four French tertiary care centres954 PA sessions
- Participants
- 86 adults
- Outcome
- Frequency and management of hypoglycaemia during unstructured PA
Methodological detailsmulticenter, real-life settings, 1 month
- Multicenter
- Real-life settings
- 1 month
Main finding
As reported in the abstract
Hypoglycaemia during PA
- TBR (<70 mg/dL) pre-exercise
- 1%
- TBR (<70 mg/dL) during exercise
- 6%
- TBR (<70 mg/dL) post-exercise (early recovery phase)
- 5%
- Sessions with clinical hypoglycaemia (one-third of episodes asymptomatic)
- 20%
- Participants with ≥1 level 2 event (<54 mg/dL)
- 38%
Observational data: associations, not effects.
Further findings
Behavioural adjustments
- Sessions using temporary targets
- 73%
- Temporary target initiated ≥1 h before PA
- 27%
- Carbohydrate intake before and during PA frequent but often suboptimally timed or dosed
Original publication
Hypoglycemia incidence and behavioural adjustments during free‐living unstructured physical activity in adults with type 1 diabetes using AID systems: Results from the RAPPID study. Diabetes Obes Metab. Published 9 September 2025. doi:10.
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