Duration of physical activity required to Ameliorate hyperglycemia without causing hypoglycemia in type 1 diabetes: A T1DEXI adults and pediatric cohort analyses

Aims: To estimate physical activity (activity) duration required to lower glucose from above target range (>180 mg/dL) to within target range (TIR: 70-180 mg/dL) in individuals with type 1 diabetes (T1D).

Methods: Continuous glucose monitoring and activity data were collected from 404 adults (28-day observation) and 149 adolescents (10-day observation) with T1D. Activities (N = 1902) with a starting glucose between 181-300 mg/dL, duration 10-60 min, and no reported meals during activity were included in the analysis. Kaplan-Meier curves were used to estimate activity duration required to drop starting glucose levels from above to within TIR.

Results: An overall starting glucose value of 181-199, 200-224, 225-249, and 250-300 mg/dL required an estimated activity duration of 15, 31, 59, and ≥ 60 min, respectively, to have a 50 % chance of reducing glucose to be within target range, with a 0-11 % incidence of hypoglycemia in the hour after activity. Activity duration requirements increased irrespective of starting glucose levels when glucose was trending upwards before activity and with zero bolus insulin on board at the start of activity. Adult and adolescent results were similar.

Conclusions: Time-limited activity is an effective means of restoring TIR when hyperglycemia exists in adolescents and adults with T1D.