Examining the Acute Glycemic Effects of Different Types of Structured Exercise Sessions in Type 1 Diabetes in a Real-World Setting: The Type 1 Diabetes and Exercise Initiative (T1DEXI)
Author:
Riddell Michael C.1ORCID, Li Zoey2, Gal Robin L.2, Calhoun Peter2ORCID, Jacobs Peter G.3ORCID, Clements Mark A.4ORCID, Martin Corby K.5, Doyle III Francis J.6, Patton Susana R.7, Castle Jessica R.8, Gillingham Melanie B.9, Beck Roy W.2, Rickels Michael R.10, Riddell Michael C., Rickels Michael R., Beck Roy W., Castle Jessica R., Calhoun Peter, Clements Mark A., Doyle Francis J., Gal Robin L., Gillingham Melanie B., Jacobs Peter G., Li Zoey, Martin Corby K., Patton Susana R., Dalton Deniz, Bocchino Laura E., Beaulieu Lindsey C., Bell Steven, Bugielski Brian, Cardenas Villamil Gabriela, Greene Ellis L., Guzzetta Russell, Mazzuoccolo Anna, Shaver Kyle, Neubig Karissa, Onengut-Gumuscu Suna, Rich Stephen S., Chen Wei-Men, Pinsonault Joe, Leitschuh Joseph, Oganessian Sos, Aiello Eleonora, Heelan Matt, Sanesanong Lisa, Rivera Brian “Mooose”, Gill Harpreet, Kollu Avinash, Glynn Earl, Lockee Brent, Barnes Mitchell,
Affiliation:
1. 1Muscle Health Research Centre, York University, Toronto, Canada 2. 2Jaeb Center for Health Research, Tampa, FL 3. 3Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR 4. 4Children’s Mercy Hospital, Kansas City, MO 5. 5Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA 6. 6Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA 7. 7Nemours Children’s Health, Jacksonville, FL 8. 8Harold Schnitzer Diabetes Health Center, Oregon Health & Science University, Portland, OR 9. 9Department of Molecular and Medical Genetics, Oregon Health & Science University, Portland, OR 10. 10Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
Abstract
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 = 165), or resistance (n = 170) exercise were analyzed. The mean (± SD) change in glucose during assigned exercise was −18 ± 39, −14 ± 32, and −9 ± 36 mg/dL for aerobic, interval, and resistance, respectively (P < 0.001), with similar results for closed-loop, standard pump, and MDI users. Time in range 70–180 mg/dL (3.9–10.0 mmol/L) was higher during the 24 h after study exercise when compared with days without exercise (mean ± SD 76 ± 20% vs. 70 ± 23%; P < 0.001).CONCLUSIONSAdults with type 1 diabetes experienced the largest drop in glucose level with aerobic exercise, followed by interval and resistance exercise, regardless of insulin delivery modality. Even in adults with well-controlled type 1 diabetes, days with structured exercise sessions contributed to clinically meaningful improvement in glucose time in range but may have slightly increased time below range.
Funder
Leona M. and Harry B. Helmsley Charitable Trust
Publisher
American Diabetes Association
Subject
Advanced and Specialized Nursing,Endocrinology, Diabetes and Metabolism,Internal Medicine
Cited by
53 articles.
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