Variation in Hypoglycemia Risk During Real-World Physical Activity in Adults with Type 1 Diabetes: Insights from the Type 1 Diabetes Exercise Initiative
Authors' conclusion
Real-world PA has a highly variable glycemic impact, with longer duration, lower starting glucose, and higher IoB increasing hypoglycemia risk. Glycemic responses differed significantly by activity type, with aerobic activities resulting in the greatest decline. These findings highlight the need for tailored strategies to mitigate PA-related hypoglycemia in T1D.
Study context
- Population
- Adults with T1D; 8171 real-world physical activity (PA) sessions comprising 45 activity types8,171 PA sessions
- Exposure
- PA-level and population-level factors and hypoglycemia risk
- Outcome
- Hypoglycemia risk (ΔCGM from PA onset to end, LBGI, hypoglycemia events) correlations with PA-level and population-level factors
Methodological detailsType 1 Diabetes Exercise Initiative data
- Type 1 Diabetes Exercise Initiative data
Main finding
As reported in the abstract
ΔCGM by PA duration · PA onset to end
60-120 min
−24
median · IQR −60–11 · mg/dL
15-30 min
−12
median · IQR −31–5 · mg/dL
- Sessions starting <50 mg/dL with hypoglycemia
- 90%
Observational data: associations, not effects.
Further findings
Glycemic variability across activity types and categories
- Low blood glucose index (LBGI) differences by category nonsignificant
- P = 0.32
- Significant glycemic variability across activity types (P < 0.05)
- Aerobic caused greatest glucose drop, followed by mixed and anaerobic (P < 0.05)
Original publication
Variation in Hypoglycemia Risk During Real-World Physical Activity in Adults with Type 1 Diabetes: Insights from the Type 1 Diabetes Exercise Initiative. Diabetes Technol Ther. Published 3 December 2025. doi:10.
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