title: Exercise management in type 1 diabetes: a consensus statement.
abstract: Type 1 diabetes is a challenging condition to manage for various physiological and behavioural reasons. Regular exercise is important, but management of different forms of physical activity is particularly difficult for both the individual with type 1 diabetes and the health-care provider. People with type 1 diabetes tend to be at least as inactive as the general population, with a large percentage of individuals not maintaining a healthy body mass nor achieving the minimum amount of moderate to vigorous aerobic activity per week. Regular exercise can improve health and wellbeing, and can help individuals to achieve their target lipid profile, body composition, and fitness and glycaemic goals. However, several additional barriers to exercise can exist for a person with diabetes, including fear of hypoglycaemia, loss of glycaemic control, and inadequate knowledge around exercise management. This Review provides an up-to-date consensus on exercise management for individuals with type 1 diabetes who exercise regularly, including glucose targets for safe and effective exercise, and nutritional and insulin dose adjustments to protect against exercise-related glucose excursions.
authors.affiliation: Muscle Health Research Centre, York University, Toronto, ON, Canada. Electronic address: mriddell@yorku.ca.
authors.forename: Michael C
authors.initials: MC
authors.lastname: Riddell
authors.affiliation: Royal Berkshire NHS Foundation Trust Centre for Diabetes and Endocrinology, Royal Berkshire Hospital, Reading, UK.
authors.forename: Ian W
authors.initials: IW
authors.lastname: Gallen
authors.affiliation: Hunter Medical Research Institute, School of Health Sciences, University of Newcastle, Rankin Park, NSW, Australia.
authors.forename: Carmel E
authors.initials: CE
authors.lastname: Smart
authors.affiliation: Division of Endocrinology and Diabetes, Department of Pediatrics, University of Washington, Seattle Children's Hospital, Seattle, WA, USA.
authors.forename: Craig E
authors.initials: CE
authors.lastname: Taplin
authors.affiliation: Department of Pediatrics, The Hospital of Halland, Kungsbacka, Sweden; Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Peter
authors.initials: P
authors.lastname: Adolfsson
authors.affiliation: Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Oxford, UK.
authors.forename: Alistair N
authors.initials: AN
authors.lastname: Lumb
authors.affiliation: Juvenile Diabetes Research Foundation, New York, NY, USA.
authors.forename: Aaron
authors.initials: A
authors.lastname: Kowalski
authors.affiliation: Department of Nutrition and Institut de Recherches Cliniques de Montréal, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.
authors.forename: Remi
authors.initials: R
authors.lastname: Rabasa-Lhoret
authors.affiliation: Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Dundee, UK.
authors.forename: Rory J
authors.initials: RJ
authors.lastname: McCrimmon
authors.affiliation: London Medical, London, UK.
authors.forename: Carin
authors.initials: C
authors.lastname: Hume
authors.affiliation: Children and Young People's Diabetes Service, University College London Hospitals NHS Foundation Trust, London, UK.
authors.forename: Francesca
authors.initials: F
authors.lastname: Annan
authors.affiliation: School of Sport Science, Exercise, and Health, Perth, WA, Australia.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Fournier
authors.affiliation: Dexcom Inc, San Diego, CA, USA.
authors.forename: Claudia
authors.initials: C
authors.lastname: Graham
authors.affiliation: Atlanta Diabetes Associates, Atlanta, GA, USA.
authors.forename: Bruce
authors.initials: B
authors.lastname: Bode
authors.affiliation: Department of Pediatrics, University of California Irvine, Irvine, CA, USA; AstraZeneca, Gaithersburg, MD, USA.
authors.forename: Pietro
authors.initials: P
authors.lastname: Galassetti
authors.affiliation: The University of Western Australia, Perth, WA, Australia; Department of Endocrinology and Diabetes, Princess Margaret Hospital for Children, Perth, WA, Australia; Telethon Kids Institute, Perth, WA, Australia.
authors.forename: Timothy W
authors.initials: TW
authors.lastname: Jones
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Colorado, School of Medicine, Aurora, CO, USA.
authors.forename: Iñigo San
authors.initials: IS
authors.lastname: Millán
authors.affiliation: Profil, Neuss, Germany.
authors.forename: Tim
authors.initials: T
authors.lastname: Heise
authors.affiliation: Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
authors.forename: Anne L
authors.initials: AL
authors.lastname: Peters
authors.affiliation: StubbaekSkole, Aabenraa, Denmark.
authors.forename: Andreas
authors.initials: A
authors.lastname: Petz
authors.affiliation: Division of Endocrinology, Boston Children's Hospital, Boston, MA, USA; Pediatric, Adolescent and Young Adult Section, Joslin Diabetes Center, Boston, MA, USA.
authors.forename: Lori M
authors.initials: LM
authors.lastname: Laffel
mesh_terms: D001786:Blood Glucose; D000075202:Contraindications; D003922:Diabetes Mellitus, Type 1; D015444:Exercise / Q000502:physiology*; D006801:Humans; D009751:Nutritional Requirements
chemical_list: D001786:Blood Glucose