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Minimizing the Risk of Exercise-Induced Glucose Fluctuations in People Living With Type 1 Diabetes Using Continuous Subcutaneous Insulin Infusion: An Overview of Strategies.

Institut de recherches cliniques de Montréal, Montréal, Québec, Canada; Département de Nutrition, Faculté de Médicine, Université de Montréal, Montréal, Québec, Canada. Institut de recherches cliniques de Montréal, Montréal, Québec, Canada; Département de Nutrition, Faculté de Médicine, Université de Montréal, Montréal, Québec, Canada; Département des Sciences Biomédicales, Faculté de Médicine, Université de Montréal, Montréal, Québec, Canada; Division of Endocrinology, McGill University, Montreal, Québec, Canada; Endocrinology Division, Montreal Diabetes Research Center, Montreal, Québec, Canada. Institut de recherches cliniques de Montréal, Montréal, Québec, Canada; Département des Sciences Biomédicales, Faculté de Médicine, Université de Montréal, Montréal, Québec, Canada. Université Lille, Unité de Recherche Pluridisciplinaire Sport Santé Société, Lille, France; Université Artois, Artois, France; Université Littoral Côte d'Opale, Dunkerque, France. Institut de recherches cliniques de Montréal, Montréal, Québec, Canada; Department of Medicine, McGill University, Montreal, Québec, Canada. Institut de recherches cliniques de Montréal, Montréal, Québec, Canada. Institut de recherches cliniques de Montréal, Montréal, Québec, Canada; Département de Nutrition, Faculté de Médicine, Université de Montréal, Montréal, Québec, Canada; Université Lille, Unité de Recherche Pluridisciplinaire Sport Santé Société, Lille, France; Université Artois, Artois, France; Université Littoral Côte d'Opale, Dunkerque, France. Electronic address: semah.tagougui@univ-lille.fr.

Canadian journal of diabetes. 2021;(7):666-676
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Abstract

Physical activity (PA) is important for individuals living with type 1 diabetes (T1D) due to its various health benefits. Nonetheless, maintaining adequate glycemic control around PA remains a challenge for many individuals living with T1D because of the difficulty in properly managing circulating insulin levels around PA. Although the most common problem is increased incidence of hypoglycemia during and after most types of PA, hyperglycemia can also occur. Accordingly, a large proportion of people living with T1D are sedentary partly due to the fear of PA-associated hypoglycemia. Continuous subcutaneous insulin infusion (CSII) offers a higher precision and flexibility to adjust insulin basal rates and boluses according to the individual's specific needs around PA practice. Indeed, for physically active patients with T1D, CSII can be a preferred option to facilitate glucose regulation. To our knowledge, there are no guidelines to manage exercise-induced hypoglycemia during PA, specifically for individuals living with T1D and using CSII. In this review, we highlight the current state of knowledge on exercise-related glucose variations, especially hypoglycemic risk and its underlying physiology. We also detail the current recommendations for insulin modulations according to the different PA modalities (type, intensity, duration, frequency) in individuals living with T1D using CSII.

Methodological quality

Publication Type : Review

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MeSH terms : Blood Glucose ; Exercise ; Insulin