Carbohydrate Requirement for Exercise in Type 1 Diabetes: Effects of Insulin Concentration

J Diabetes Sci Technol. 2020 Nov;14(6):1116-1121. doi: 10.1177/1932296819826962. Epub 2019 Feb 15.

Abstract

Physical activity is a keystone of a healthy lifestyle as well as of management of patients with type 1 diabetes. The risk of exercise-induced hypoglycemia, however, is a great challenge for these patients. The glycemic response to exercise depends upon several factors concerning the patient him/herself (eg, therapy, glycemic control, training level) and the characteristics of the exercise performed. Only in-depth knowledge of these factors will allow to develop individualized strategies minimizing the risk of hypoglycemia. The main factors affecting the exercise-induced hypoglycemia in patients with T1D have been analyzed, including the effects of insulin concentration. A model is discussed, which has the potential to become the basis for providing patients with individualized suggestions to keep constant glucose levels on each exercise occasion.

Keywords: carbohydrates; exercise; hypoglycemia; insulin; model; type 1 diabetes.

MeSH terms

  • Biomarkers / blood
  • Blood Glucose / drug effects*
  • Blood Glucose / metabolism
  • Decision Support Techniques
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / diagnosis
  • Diabetes Mellitus, Type 1 / physiopathology
  • Diabetes Mellitus, Type 1 / therapy*
  • Dietary Carbohydrates / administration & dosage*
  • Dietary Carbohydrates / adverse effects
  • Dietary Carbohydrates / metabolism
  • Humans
  • Hypoglycemia / blood
  • Hypoglycemia / chemically induced
  • Hypoglycemia / prevention & control
  • Hypoglycemic Agents / administration & dosage*
  • Hypoglycemic Agents / adverse effects
  • Insulin / administration & dosage*
  • Insulin / adverse effects
  • Models, Biological
  • Risk Assessment
  • Risk Factors
  • Treatment Outcome

Substances

  • Biomarkers
  • Blood Glucose
  • Dietary Carbohydrates
  • Hypoglycemic Agents
  • Insulin