Physical activity in children and adolescents with Type 1 diabetes

Abstract

This chapter explores the multifaceted role of physical activity in type 1 diabetes management during childhood and adolescence. In addition to improved cardiovascular and metabolic health typically associated with physical activity, there are several diabetes-specific benefits of regular activity. For example, improved insulin sensitivity in insulin sensitivity that may be particularly important for children with type 1 diabetes approaching puberty when insulin resistance is known to increase, especially in females. Similarly, there are important diabetes-specific metabolic differences in response to physical activity that require consideration for blood glucose excursion management. Type, duration, and intensity of activity influence metabolic response in type 1 diabetes. For example, during aerobic activity, skeletal muscle glucose uptake increases to generate energy for muscle contraction, which suppresses hepatic gluconeogenesis and thus promotes a decrease in blood glucose levels and increased risk of hypoglycaemia. Intermittent, intense, or anaerobic activity can induce transient and often dramatic hyperglycaemia due to the release of the hormones epinephrine and glucagon. This rise in blood glucose can be followed by hypoglycaemia in the hours after activity. Within this chapter, the need for individualised and informed planning for safe participation in PA and exercise for children and adolescents is explored.