title: Managing insulin therapy during exercise in type 1 diabetes mellitus.
abstract: BACKGROUND
  Exercise is integral to the life of T1DM subjects. Several factors influence the metabolic response to exercise in these patients. Despite physical and psychological benefits of exercise, its hypo- and hyperglycemic effects may cause discouragement from participation in sports and games.
  
  
  OBJECTIVE
  To use existing evidence from literature to provide practical indications for the management of insulin therapy in subjects with T1DM who practice sports or physical activities.
  
  
  METHODS
  Bibliographic research was performed on PubMed and the main Systematic Review and Guidelines database were also searched.
  
  
  RESULTS
  Existing guidelines are useful but the exact adjustments of insulin dose must be made on an individual basis and these adjustments can be made only by "trial and error" approach.
  
  
  CONCLUSIONS
  These clinical indications may be a starting point from which health care providers can find practical advices for each patient.
authors.affiliation: Juvenile Diabetes Centre, Florence, Italy. s.toni@meyer.it
authors.forename: Sonia
authors.initials: S
authors.lastname: Toni
authors.forename: Maria Francesca
authors.initials: MF
authors.lastname: Reali
authors.forename: Federica
authors.initials: F
authors.lastname: Barni
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Lenzi
authors.forename: Filippo
authors.initials: F
authors.lastname: Festini
mesh_terms: D000042:Absorption; D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism; D015190:Blood Glucose Self-Monitoring; D002648:Child; D002940:Circadian Rhythm; D003131:Combined Modality Therapy; D003922:Diabetes Mellitus, Type 1 / Q000178:diet therapy / Q000188:drug therapy* / Q000503:physiopathology / Q000628:therapy; D004300:Doping in Sports; D004334:Drug Administration Schedule; D004435:Eating; D015444:Exercise; D005081:Exercise Therapy / Q000009:adverse effects; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology / Q000517:prevention & control; D007003:Hypoglycemia / Q000209:etiology / Q000517:prevention & control; D007279:Injections, Subcutaneous; D007328:Insulin / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D007332:Insulin Infusion Systems; D008685:Meteorological Concepts; D017410:Practice Guidelines as Topic; D013177:Sports
chemical_list: D001786:Blood Glucose; D007328:Insulin