Exercise management in type 1 diabetes: a consensus statement

The Lancet Diabetes and Endocrinology

Volumn 5, Issue 5, 2017, Pages 377-390

  Riddell, Michael C ^a   Gallen, Ian W ^b   Smart, Carmel E ^c   Taplin, Craig E ^d   Adolfsson, Peter ^e,f   Lumb, Alistair N ^g   Kowalski, Aaron ^h   Rabasa Lhoret, Remi ⁱ   McCrimmon, Rory J ^j   Hume, Carin ^k   Annan, Francesca ^l   Fournier, Paul A ^m   Graham, Claudia ^q   Bode, Bruce ^r   Galassetti, Pietro ^s,t   Jones, Timothy W ^n,o,p   Millán, Iñigo San ^u   Heise, Tim ^v   Peters, Anne L ^w   Petz, Andreas ^x   Laffel, Lori M ^y,z   more..

^a YORK UNIVERSITY   (Canada)

^b ROYAL BERKSHIRE HOSPITAL   (United Kingdom)

^c UNIVERSITY OF NEWCASTLE   (Australia)

^d UNIVERSITY OF WASHINGTON   (United States)

^e The hospital of Halland Kungsbacka   (Sweden)

^f SAHLGRENSKA ACADEMY AT UNIVERSITY OF GOTHENBURG   (Sweden)

^g CHURCHILL HOSPITAL   (United Kingdom)

^h Juvenile Diabetes Research Foundation International   (United States)

ⁱ CLIN RESEARCH INSTITUTE OF MONTREAL   (Canada)

^j UNIVERSITY OF DUNDEE   (United Kingdom)

^k London Medical Centre   (United Kingdom)

^l UNIVERSITY COLLEGE LONDON HOSPITALS   (United Kingdom)

^m Exercise and Health   (Australia)

ⁿ UNIVERSITY OF WESTERN AUSTRALIA   (Australia)

^o PRINCESS MARGARET HOSPITAL FOR CHILDREN   (Australia)

^p UNIVERSITY OF WESTERN AUSTRALIA   (Australia)

^q DexCom Inc   (United States)

^r ATLANTA DIABETES ASSOCIATES   (United States)

^s UNIVERSITY OF CALIFORNIA   (United States)

^t ASTRAZENECA   (United Kingdom)

^u UNIVERSITY OF COLORADO SCHOOL OF MEDICINE   (United States)

^v Profil   (Germany)

^w UNIVERSITY OF SOUTHERN CALIFORNIA   (United States)

^x StubbaekSkole   (Denmark)

^y BOSTON CHILDREN S HOSPITAL   (United States)

^z JOSLIN DIABETES CENTER   (United States)

more..

Author keywords

[No Author keywords available]

Indexed keywords

HEMOGLOBIN A1C;

ASSESSMENT OF HUMANS; BODY COMPOSITION; BODY MASS; ENERGY EXPENDITURE; EXERCISE; FITNESS; GLUCOSE BLOOD LEVEL; GLYCEMIC INDEX; HUMAN; HYPOGLYCEMIA; INSULIN DEPENDENT DIABETES MELLITUS; INSULIN INFUSION; KETOACIDOSIS; LIPID BLOOD LEVEL; LIPOLYSIS; NUTRITIONAL SUPPORT; PHYSICAL ACTIVITY; PHYSICAL ACTIVITY READINESS MEDICAL EXAMINATION QUESTIONNAIRE; PHYSICAL ACTIVITY READINESS QUESTIONNAIRE; PRIORITY JOURNAL; REVIEW; CONTRAINDICATION; NUTRITIONAL REQUIREMENT; PHYSIOLOGY;

BLOOD GLUCOSE; CONTRAINDICATIONS; DIABETES MELLITUS, TYPE 1; EXERCISE; HUMANS; NUTRITIONAL REQUIREMENTS;

EID: 85010189078     PISSN: 22138587     EISSN: 22138595     Source Type: Journal    
DOI: 10.1016/S2213-8587(17)30014-1     Document Type: Review

References (125)

1. 1 Mayor, S, Insulin pumps improve glucose control in children with type 1 diabetes, study finds. BMJ, 351, 2015, h5998.
2. 2 McKnight, JA, Wild, SH, Lamb, MJE, et al. Glycaemic control of Type 1 diabetes in clinical practice early in the 21st century: an international comparison. Diabet Med J Br Diabet Assoc 32 (2015), 1036–1050.
3. 3 Bohn, B, Herbst, A, Pfeifer, M, et al. Impact of physical activity on glycemic control and prevalence of cardiovascular risk factors in adults with type 1 diabetes: a cross-sectional multicenter study of 18,028 patients. Diabetes Care 38 (2015), 1536–1543.
4. 4 McCarthy, MM, Funk, M, Grey, M, Cardiovascular health in adults with type 1 diabetes. Prev Med 91 (2016), 138–143.
5. 5 Herbst, A, Kordonouri, O, Schwab, KO, Schmidt, F, Holl, RW, for the DPV Initiative of the German Working Group for Pediatric Diabetology Germany. Impact of physical activity on cardiovascular risk factors in children with type 1 diabetes: a multicenter study of 23,251 patients. Diabetes Care 30 (2007), 2098–2100.
6. 6 Quirk, H, Blake, H, Tennyson, R, Randell, TL, Glazebrook, C, Physical activity interventions in children and young people with type 1 diabetes mellitus: a systematic review with meta-analysis. Diabet Med J Br Diabet Assoc 31 (2014), 1163–1173.
7. 7 Miller, RG, Mahajan, HD, Costacou, T, Sekikawa, A, Anderson, SJ, Orchard, TJ, A contemporary estimate of total mortality and cardiovascular disease risk in young adults with type 1 diabetes: the Pittsburgh Epidemiology of Diabetes Complications Study. Diabetes Care 39 (2016), 2296–2303.
8. 8 Katz, M, Giani, E, Laffel, L, Challenges and opportunities in the management of cardiovascular risk factors in youth with type 1 diabetes: lifestyle and beyond. Curr Diab Rep, 15, 2015, 119.
9. 9 Kriska, AM, LaPorte, RE, Patrick, SL, Kuller, LH, Orchard, TJ, The association of physical activity and diabetic complications in individuals with insulin-dependent diabetes mellitus: the Epidemiology of Diabetes Complications Study–VII. J Clin Epidemiol 44 (1991), 1207–1214.
10. 10 Chimen, M, Kennedy, A, Nirantharakumar, K, Pang, TT, Andrews, R, Narendran, P, What are the health benefits of physical activity in type 1 diabetes mellitus? A literature review. Diabetologia 55 (2012), 542–551.
11. 11 Pierre-Louis, B, Guddati, AK, Khyzar Hayat Syed, M, et al. Exercise capacity as an independent risk factor for adverse cardiovascular outcomes among nondiabetic and diabetic patients. Arch Med Sci AMS 10 (2014), 25–32.
12. 12 Brazeau, AS, Rabasa-Lhoret, R, Strychar, I, Mircescu, H, Barriers to physical activity among patients with type 1 diabetes. Diabetes Care 31 (2008), 2108–2109.
13. 13 Jabbour, G, Henderson, M, Mathieu, ME, Barriers to active lifestyles in children with type 1 diabetes. Can J Diabetes 40 (2016), 170–172.
14. 14 Lascar, N, Kennedy, A, Hancock, B, et al. Attitudes and barriers to exercise in adults with type 1 diabetes (T1DM) and how best to address them: a qualitative study. PLoS One, 9, 2014, e108019.
15. 15 Colberg, SR, Sigal, RJ, Yardley, JE, et al. Physical activity/exercise and diabetes: a position statement of the American Diabetes Association. Diabetes Care 39 (2016), 2065–2079.
16. 16 Robertson, K, Riddell, MC, Guinhouya, BC, Adolfsson, P, Hanas, R, Exercise in children and adolescents with diabetes. Pediatr Diabetes 15:suppl 20 (2014), 203–223.
17. 17 Galler, A, Lindau, M, Ernert, A, Thalemann, R, Raile, K, Associations between media consumption habits, physical activity, socioeconomic status, and glycemic control in children, adolescents, and young adults with type 1 diabetes. Diabetes Care 34 (2011), 2356–2359.
18. 18 Batacan, RB, Duncan, MJ, Dalbo, VJ, Tucker, PS, Fenning, AS, Effects of high-intensity interval training on cardiometabolic health: a systematic review and meta-analysis of intervention studies. Br J Sports Med, 2016, 10.1136/bjsports-2015-095841 published online Oct 20.
19. 19 Mitranun, W, Deerochanawong, C, Tanaka, H, Suksom, D, Continuous vs interval training on glycemic control and macro- and microvascular reactivity in type 2 diabetic patients. Scand J Med Sci Sports 24 (2014), e69–e76.
20. 20 Yardley, JE, Hay, J, Abou-Setta, AM, Marks, SD, McGavock, J, A systematic review and meta-analysis of exercise interventions in adults with type 1 diabetes. Diabetes Res Clin Pract 106 (2014), 393–400.
21. 21 Camacho, RC, Galassetti, P, Davis, SN, Wasserman, DH, Glucoregulation during and after exercise in health and insulin-dependent diabetes. Exerc Sport Sci Rev 33 (2005), 17–23.
22. 22 Ploug, T, Galbo, H, Richter, EA, Increased muscle glucose uptake during contractions: no need for insulin. Am J Physiol 247 (1984), E726–E731.
23. 23 Coker, RH, Kjaer, M, Glucoregulation during exercise: the role of the neuroendocrine system. Sports Med Auckl NZ 35 (2005), 575–583.
24. 24 Coyle, EF, Substrate utilization during exercise in active people. Am J Clin Nutr 61:suppl 4 (1995), 968S–979S.
25. 25 Venables, MC, Achten, J, Jeukendrup, AE, Determinants of fat oxidation during exercise in healthy men and women: a cross-sectional study. J Appl Physiol 98 (2005), 160–167.
26. 26 van Loon, LJ, Greenhaff, PL, Constantin-Teodosiu, D, Saris, WH, Wagenmakers, AJ, The effects of increasing exercise intensity on muscle fuel utilisation in humans. J Physiol 536 (2001), 295–304.
27. 27 Fahey, AJ, Paramalingam, N, Davey, RJ, Davis, EA, Jones, TW, Fournier, PA, The effect of a short sprint on postexercise whole-body glucose production and utilization rates in individuals with type 1 diabetes mellitus. J Clin Endocrinol Metab 97 (2012), 4193–4200.
28. 28 Harmer, AR, Chisholm, DJ, McKenna, MJ, et al. High-intensity training improves plasma glucose and acid-base regulation during intermittent maximal exercise in type 1 diabetes. Diabetes Care 30 (2007), 1269–1271.
29. 29 Bally, L, Laimer, M, Stettler, C, Exercise-associated glucose metabolism in individuals with type 1 diabetes mellitus. Curr Opin Clin Nutr Metab Care 18 (2015), 428–433.
30. 30 Mallad, A, Hinshaw, L, Schiavon, M, et al. Exercise effects on postprandial glucose metabolism in type 1 diabetes: a triple tracer approach. Am J Physiol Endocrinol Metab 308 (2015), E1106–E1115.
31. 31 Frayn, KN, Karpe, F, Regulation of human subcutaneous adipose tissue blood flow. Int J Obes 38 (2014), 1019–1026.
32. 32 McAuley, SA, Horsburgh, JC, Ward, GM, et al. Insulin pump basal adjustment for exercise in type 1 diabetes: a randomised crossover study. Diabetologia 59 (2016), 1636–1644.
33. 33 Tansey, MJ, Tsalikian, E, Beck, RW, et al. The effects of aerobic exercise on glucose and counterregulatory hormone concentrations in children with type 1 diabetes. Diabetes Care 29 (2006), 20–25.
34. 34 Riddell, MC, Bar-Or, O, Ayub, BV, Calvert, RE, Heigenhauser, GJ, Glucose ingestion matched with total carbohydrate utilization attenuates hypoglycemia during exercise in adolescents with IDDM. Int J Sport Nutr 9 (1999), 24–34.
35. 35 García-García, F, Kumareswaran, K, Hovorka, R, Hernando, ME, Quantifying the acute changes in glucose with exercise in type 1 diabetes: a systematic review and meta-analysis. Sports Med 45 (2015), 587–599.
36. 36 Al Khalifah, RA, Suppíre, C, Haidar, A, Rabasa-Lhoret, R, Ladouceur, M, Legault, L, Association of aerobic fitness level with exercise-induced hypoglycaemia in type 1 diabetes. Diabet Med 33 (2016), 1686–1690.
37. 37 Harmer, AR, Chisholm, DJ, McKenna, MJ, et al. Sprint training increases muscle oxidative metabolism during high-intensity exercise in patients with type 1 diabetes. Diabetes Care 31 (2008), 2097–2102.
38. 38 Singhvi, A, Tansey, MJ, Janz, K, Zimmerman, MB, Tsalikian, E, Aerobic fitness and glycemic variability in adolescents with type 1 diabetes. Endocr Pract 20 (2014), 566–570.
39. 39 Zander, E, Bruns, W, Wulfert, P, et al. Muscular exercise in type I-diabetics. I. Different metabolic reactions during heavy muscular work in dependence on actual insulin availability. Exp Clin Endocrinol 82 (1983), 78–90.
40. 40 Berger, M, Berchtold, P, Cüppers, HJ, et al. Metabolic and hormonal effects of muscular exercise in juvenile type diabetics. Diabetologia 13 (1977), 355–365.
41. 41 Yardley, JE, Kenny, GP, Perkins, BA, et al. Resistance versus aerobic exercise: acute effects on glycemia in type 1 diabetes. Diabetes Care 36 (2013), 537–542.
42. 42 Turner, D, Luzio, S, Gray, BJ, et al. Impact of single and multiple sets of resistance exercise in type 1 diabetes. Scand J Med Sci Sports 25 (2015), e99–109.
43. 43 Guelfi, KJ, Ratnam, N, Smythe, GA, Jones, TW, Fournier, PA, Effect of intermittent high-intensity compared with continuous moderate exercise on glucose production and utilization in individuals with type 1 diabetes. Am J Physiol Endocrinol Metab 292 (2007), E865–E870.
44. 44 Yardley, JE, Kenny, GP, Perkins, BA, et al. Effects of performing resistance exercise before versus after aerobic exercise on glycemia in type 1 diabetes. Diabetes Care 35 (2012), 669–675.
45. 45 Bally, L, Zueger, T, Buehler, T, et al. Metabolic and hormonal response to intermittent high-intensity and continuous moderate intensity exercise in individuals with type 1 diabetes: a randomised crossover study. Diabetologia 59 (2016), 776–784.
46. 46 Davey, RJ, Paramalingam, N, Retterath, AJ, et al. Antecedent hypoglycaemia does not diminish the glycaemia-increasing effect and glucoregulatory responses of a 10 s sprint in people with type 1 diabetes. Diabetologia 57 (2014), 1111–1118.
47. 47 Teich, T, Riddell, MC, The enhancement of muscle insulin sensitivity after exercise: a Rac1-independent handoff to some other player?. Endocrinology 157 (2016), 2999–3001.
48. 48 Gomez, AM, Gomez, C, Aschner, P, et al. Effects of performing morning versus afternoon exercise on glycemic control and hypoglycemia frequency in type 1 diabetes patients on sensor-augmented insulin pump therapy. J Diabetes Sci Technol 9 (2015), 619–624.
49. 49 Turner, D, Luzio, S, Gray, BJ, et al. Algorithm that delivers an individualized rapid-acting insulin dose after morning resistance exercise counters post-exercise hyperglycaemia in people with type 1 diabetes. Diabet Med 3 (2016), 506–510.
50. 50 Tanenberg, RJ, Newton, CA, Drake, AJ, Confirmation of hypoglycemia in the “dead-in-bed” syndrome, as captured by a retrospective continuous glucose monitoring system. Endocr Pract 16 (2010), 244–248.
51. 51 Maran, A, Pavan, P, Bonsembiante, B, et al. Continuous glucose monitoring reveals delayed nocturnal hypoglycemia after intermittent high-intensity exercise in nontrained patients with type 1 diabetes. Diabetes Technol Ther 12 (2010), 763–768.
52. 52 Moser, O, Tschakert, G, Mueller, A, et al. Effects of high-intensity interval exercise versus moderate continuous exercise on glucose homeostasis and hormone response in patients with type 1 diabetes mellitus using novel ultra-long-acting insulin. PloS One, 10, 2015, e0136489.
53. 53 Iscoe, KE, Riddell, MC, Continuous moderate-intensity exercise with or without intermittent high-intensity work: effects on acute and late glycaemia in athletes with type 1 diabetes mellitus. Diabet Med 28 (2011), 824–832.
54. 54 Kennedy, A, Nirantharakumar, K, Chimen, M, et al. Does exercise improve glycaemic control in type 1 diabetes? A systematic review and meta-analysis. PloS One, 8, 2013, e58861.
55. 55 Adolfsson, P, Mattsson, S, Jendle, J, Evaluation of glucose control when a new strategy of increased carbohydrate supply is implemented during prolonged physical exercise in type 1 diabetes. Eur J Appl Physiol 115 (2015), 2599–2607.
56. 56 Rabasa-Lhoret, R, Bourque, J, Ducros, F, Chiasson, JL, Guidelines for premeal insulin dose reduction for postprandial exercise of different intensities and durations in type 1 diabetic subjects treated intensively with a basal-bolus insulin regimen (ultralente-lispro). Diabetes Care 24 (2001), 625–630.
57. 57 Campbell, MD, Walker, M, Trenell, MI, et al. Metabolic implications when employing heavy pre- and post-exercise rapid-acting insulin reductions to prevent hypoglycaemia in type 1 diabetes patients: a randomised clinical trial. PloS One, 9, 2014, e97143.
58. 58 Dubé, M-C, Weisnagel, SJ, Prud'homme, D, Lavoie, C, Is early and late post-meal exercise so different in type 1 diabetic lispro users?. Diabetes Res Clin Pract 72 (2006), 128–134.
59. 59 Thomas, DT, Erdman, KA, Burke, LM, Position of the Academy of Nutrition and Dietetics, Dietitians of Canada, and the American College of Sports Medicine: nutrition and athletic performance. J Acad Nutr Diet 116 (2016), 501–528.
60. 60 Burke, LM, Hawley, JA, Wong, SHS, Jeukendrup, AE, Carbohydrates for training and competition. J Sports Sci 29:suppl 1 (2011), S17–S27.
61. 61 Jeukendrup, A, A step towards personalized sports nutrition: carbohydrate intake during exercise. Sports Med Auckl NZ 44:suppl 1 (2014), S25–S33.
62. 62 Kelly, D, Hamilton, JK, Riddell, MC, Blood glucose levels and performance in a sports camp for adolescents with type 1 diabetes mellitus: a field study. Int J Pediatr, 2010, 2010, 216167.
63. 63 Graveling, AJ, Frier, BM, Risks of marathon running and hypoglycaemia in type 1 diabetes. Diabet Med 27 (2010), 585–588.
64. 64 Galassetti, P, Tate, D, Neill, RA, Richardson, A, Leu, S-Y, Davis, SN, Effect of differing antecedent hypoglycemia on counterregulatory responses to exercise in type 1 diabetes. Am J Physiol Endocrinol Metab 290 (2006), E1109–E1117.
65. 65 Riddell, MC, Burr, J, Evidence-based risk assessment and recommendations for physical activity clearance: diabetes mellitus and related comorbidities. Appl Physiol Nutr Metab 36:suppl 1 (2011), S154–S189.
66. 66 American Diabetes Association. (4) Foundations of care: education, nutrition, physical activity, smoking cessation, psychosocial care, and immunization. Diabetes Care 38:suppl (2015), S20–S30.
67. 67 Franc, S, Daoudi, A, Pochat, A, et al. Insulin-based strategies to prevent hypoglycaemia during and after exercise in adult patients with type 1 diabetes on pump therapy: the DIABRASPORT randomized study. Diabetes Obes Metab 17 (2015), 1150–1157.
68. 68 Sawka, MN, Burke, LM, Eichner, ER, Maughan, RJ, Montain, SJ, Stachenfeld, NS, Exercise and fluid replacement. Med Sci Sports Exerc 39 (2007), 377–390.
69. 69 Loucks, AB, Kiens, B, Wright, HH, Energy availability in athletes. J Sports Sci 29:suppl 1 (2011), S7–15.
70. 70 Frankenfield, D, Roth-Yousey, L, Compher, C, Comparison of predictive equations for resting metabolic rate in healthy nonobese and obese adults: a systematic review. J Am Diet Assoc 105 (2005), 775–789.
71. 71 Murphy, CH, Hector, AJ, Phillips, SM, Considerations for protein intake in managing weight loss in athletes. Eur J Sport Sci 15 (2015), 21–28.
72. 72 Phillips, SM, Dietary protein requirements and adaptive advantages in athletes. Br J Nutr 108:suppl 2 (2012), S158–S167.
73. 73 Phillips, SM, Chevalier, S, Leidy, HJ, Protein “requirements” beyond the RDA: implications for optimizing health. Appl Physiol Nutr Metab 41 (2016), 565–572.
74. 74 Mettler, S, Mitchell, N, Tipton, KD, Increased protein intake reduces lean body mass loss during weight loss in athletes. Med Sci Sports Exerc 42 (2010), 326–337.
75. 75 Shetty, VB, Fournier, PA, Davey, RJ, et al. Effect of exercise intensity on glucose requirements to maintain euglycemia during exercise in type 1 diabetes. J Clin Endocrinol Metab 101 (2016), 972–980.
76. 76 Hernandez, JM, Moccia, T, Fluckey, JD, Ulbrecht, JS, Farrell, PA, Fluid snacks to help persons with type 1 diabetes avoid late onset postexercise hypoglycemia. Med Sci Sports Exerc 32 (2000), 904–910.
77. 77 Beelen, M, Burke, LM, Gibala, MJ, van Loon L, JC, Nutritional strategies to promote postexercise recovery. Int J Sport Nutr Exerc Metab 20 (2010), 515–532.
78. 78 van Albada, ME, Bakker-van Waarde, WM, Recurrent nightly ketosis after prolonged exercise in type 1 diabetes—the need for glycogen replacement strategies. Case report and review of literature. Pediatr Diabetes 17 (2016), 531–534.
79. 79 Bracken, RM, Page, R, Gray, B, et al. Isomaltulose improves glycemia and maintains run performance in type 1 diabetes. Med Sci Sports Exerc 44 (2012), 800–808.
80. 80 Campbell, MD, Walker, M, Trenell, MI, et al. A low-glycemic index meal and bedtime snack prevents postprandial hyperglycemia and associated rises in inflammatory markers, providing protection from early but not late nocturnal hypoglycemia following evening exercise in type 1 diabetes. Diabetes Care 37 (2014), 1845–1853.
81. 81 Perrone, C, Laitano, O, Meyer, F, Effect of carbohydrate ingestion on the glycemic response of type 1 diabetic adolescents during exercise. Diabetes Care 28 (2005), 2537–2538.
82. 82 Burke, LM, Re-examining high-fat diets for sports performance: did we call the “nail in the coffin” too soon?. Sports Med Auckl NZ 45:suppl 1 (2015), 33–49.
83. 83 Burke, LM, Hawley, JA, Angus, DJ, et al. Adaptations to short-term high-fat diet persist during exercise despite high carbohydrate availability. Med Sci Sports Exerc 34 (2002), 83–91.
84. 84 Bartlett, JD, Hawley, JA, Morton, JP, Carbohydrate availability and exercise training adaptation: too much of a good thing?. Eur J Sport Sci 15 (2015), 3–12.
85. 85 Paluska, SA, Caffeine and exercise. Curr Sports Med Rep 2 (2003), 213–219.
86. 86 Zaharieva, DP, Miadovnik, LA, Rowan, CP, Gumieniak, RJ, Jamnik, VK, Riddell, MC, Effects of acute caffeine supplementation on reducing exercise-associated hypoglycaemia in individuals with type 1 diabetes mellitus. Diabet Med 33 (2016), 488–496.
87. 87 Frid, A, Ostman, J, Linde, B, Hypoglycemia risk during exercise after intramuscular injection of insulin in thigh in IDDM. Diabetes Care 13 (1990), 473–477.
88. 88 Hirsch, L, Byron, K, Gibney, M, Intramuscular risk at insulin injection sites—measurement of the distance from skin to muscle and rationale for shorter-length needles for subcutaneous insulin therapy. Diabetes Technol Ther 16 (2014), 867–873.
89. 89 Hildebrandt, P, Subcutaneous absorption of insulin in insulin-dependent diabetic patients. Influence of species, physico-chemical properties of insulin and physiological factors. Dan Med Bull 38 (1991), 337–346.
90. 90 Rönnemaa, T, Koivisto, VA, Combined effect of exercise and ambient temperature on insulin absorption and postprandial glycemia in type I patients. Diabetes Care 11 (1988), 769–773.
91. 91 Peter, R, Luzio, SD, Dunseath, G, et al. Effects of exercise on the absorption of insulin glargine in patients with type 1 diabetes. Diabetes Care 28 (2005), 560–565.
92. 92 Bell, KJ, Smart, CE, Steil, GM, Brand-Miller, JC, King, B, Wolpert, HA, Impact of fat, protein, and glycemic index on postprandial glucose control in type 1 diabetes: implications for intensive diabetes management in the continuous glucose monitoring era. Diabetes Care 38 (2015), 1008–1015.
93. 93 Breton, MD, Kovatchev, BP, Impact of blood glucose self-monitoring errors on glucose variability, risk for hypoglycemia, and average glucose control in type 1 diabetes: an in silico study. J Diabetes Sci Technol 4 (2010), 562–570.
94. 94 Tonyushkina, K, Nichols, JH, Glucose meters: a review of technical challenges to obtaining accurate results. J Diabetes Sci Technol 3 (2009), 971–980.
95. 95 Castle, JR, Jacobs, PG, Nonadjunctive Use of continuous glucose monitoring for diabetes treatment decisions. J Diabetes Sci Technol 10 (2016), 1169–1173.
96. 96 Bally, L, Zueger, T, Pasi, N, Carlos, C, Paganini, D, Stettler, C, Accuracy of continuous glucose monitoring during differing exercise conditions. Diabetes Res Clin Pract 112 (2016), 1–5.
97. 97 Davey, RJ, Low, C, Jones, TW, Fournier, PA, Contribution of an intrinsic lag of continuous glucose monitoring systems to differences in measured and actual glucose concentrations changing at variable rates in vitro. J Diabetes Sci Technol 4 (2010), 1393–1399.
98. 98 Richardson, T, Weiss, M, Thomas, P, Kerr, D, Day after the night before: influence of evening alcohol on risk of hypoglycemia in patients with type 1 diabetes. Diabetes Care 28 (2005), 1801–1802.
99. 99 Blaak, E, Sex differences in the control of glucose homeostasis. Curr Opin Clin Nutr Metab Care 11 (2008), 500–504.
100. 100 Deane, AM, Horowitz, M, Dysglycaemia in the critically ill—significance and management. Diabetes Obes Metab 15 (2013), 792–801.
101. 101 Campbell, MD, Walker, M, Trenell, MI, et al. Large pre- and postexercise rapid-acting insulin reductions preserve glycemia and prevent early- but not late-onset hypoglycemia in patients with type 1 diabetes. Diabetes Care 36 (2013), 2217–2224.
102. 102 Mauvais-Jarvis, F, Sobngwi, E, Porcher, R, et al. Glucose response to intense aerobic exercise in type 1 diabetes: maintenance of near euglycemia despite a drastic decrease in insulin dose. Diabetes Care 26 (2003), 1316–1317.
103. 103 West, DJ, Morton, RD, Bain, SC, Stephens, JW, Bracken, RM, Blood glucose responses to reductions in pre-exercise rapid-acting insulin for 24 h after running in individuals with type 1 diabetes. J Sports Sci 28 (2010), 781–788.
104. 104 Bracken, RM, West, DJ, Stephens, JW, Kilduff, LP, Luzio, S, Bain, SC, Impact of pre-exercise rapid-acting insulin reductions on ketogenesis following running in type 1 diabetes. Diabet Med 28 (2011), 218–222.
105. 105 West, DJ, Stephens, JW, Bain, SC, et al. A combined insulin reduction and carbohydrate feeding strategy 30 min before running best preserves blood glucose concentration after exercise through improved fuel oxidation in type 1 diabetes mellitus. J Sports Sci 29 (2011), 279–289.
106. 106 Campbell, MD, Walker, M, Bracken, RM, et al. Insulin therapy and dietary adjustments to normalize glycemia and prevent nocturnal hypoglycemia after evening exercise in type 1 diabetes: a randomized controlled trial. BMJ Open Diabetes Res Care, 3, 2015, e000085.
107. 107 Arutchelvam, V, Heise, T, Dellweg, S, Elbroend, B, Minns, I, Home, PD, Plasma glucose and hypoglycaemia following exercise in people with type 1 diabetes: a comparison of three basal insulins. Diabet Med 26 (2009), 1027–1032.
108. 108 Heise, T, Bain, SC, Bracken, RM, et al. Similar risk of exercise-related hypoglycaemia for insulin degludec to that for insulin glargine in patients with type 1 diabetes: a randomized cross-over trial. Diabetes Obes Metab 18 (2016), 196–199.
109. 109 Heinemann, L, Nosek, L, Kapitza, C, Schweitzer, M-A, Krinelke, L, Changes in basal insulin infusion rates with subcutaneous insulin infusion: time until a change in metabolic effect is induced in patients with type 1 diabetes. Diabetes Care 32 (2009), 1437–1439.
110. 110 Diabetes Research in Children Network (DirecNet) Study Group. Prevention of hypoglycemia during exercise in children with type 1 diabetes by suspending basal insulin. Diabetes Care 29 (2006), 2200–2204.
111. 111 Admon, G, Weinstein, Y, Falk, B, et al. Exercise with and without an insulin pump among children and adolescents with type 1 diabetes mellitus. Pediatrics 116 (2005), e348–e355.
112. 112 Yardley, JE, Iscoe, KE, Sigal, RJ, Kenny, GP, Perkins, BA, Riddell, MC, Insulin pump therapy is associated with less post-exercise hyperglycemia than multiple daily injections: an observational study of physically active type 1 diabetes patients. Diabetes Technol Ther 15 (2013), 84–88.
113. 113 Taplin, CE, Cobry, E, Messer, L, McFann, K, Chase, HP, Fiallo-Scharer, R, Preventing post-exercise nocturnal hypoglycemia in children with type 1 diabetes. J Pediatr, 157, 2010, 784 88.e1.
114. 114 Frier, BM, Hypoglycaemia in diabetes mellitus: epidemiology and clinical implications. Nat Rev Endocrinol 10 (2014), 711–722.
115. 115 Davey, RJ, Howe, W, Paramalingam, N, et al. The effect of midday moderate-intensity exercise on postexercise hypoglycemia risk in individuals with type 1 diabetes. J Clin Endocrinol Metab 98 (2013), 2908–2914.
116. 116 Garg, SK, Brazg, RL, Bailey, TS, et al. Hypoglycemia begets hypoglycemia: the order effect in the ASPIRE in-clinic study. Diabetes Technol Ther 16 (2014), 125–130.
117. 117 Chu, L, Hamilton, J, Riddell, MC, Clinical management of the physically active patient with type 1 diabetes. Phys Sportsmed 39 (2011), 64–77.
118. 118 Binek, A, Rembierz-Knoll, A, Polańska, J, Jarosz-Chobot, P, Reasons for the discontinuation of therapy of personal insulin pump in children with type 1 diabetes. Pediatr Endocrinol Diabetes Metab 21 (2016), 65–69.
119. 119 Riddell, MC, Milliken, J, Preventing exercise-induced hypoglycemia in type 1 diabetes using real-time continuous glucose monitoring and a new carbohydrate intake algorithm: an observational field study. Diabetes Technol Ther 13 (2011), 819–825.
120. 120 Adolfsson, P, Ornhagen, H, Jendle, J, The benefits of continuous glucose monitoring and a glucose monitoring schedule in individuals with type 1 diabetes during recreational diving. J Diabetes Sci Technol 2 (2008), 778–784.
121. 121 Yardley, JE, Sigal, RJ, Kenny, GP, Riddell, MC, Lovblom, LE, Perkins, BA, Point accuracy of interstitial continuous glucose monitoring during exercise in type 1 diabetes. Diabetes Technol Ther 15 (2013), 46–49.
122. 122 Taleb, N, Emami, A, Suppere, C, et al. Comparison of two continuous glucose monitoring systems, Dexcom G4 Platinum and Medtronic Paradigm Veo Enlite System, at rest and during exercise. Diabetes Technol Ther 18 (2016), 561–577.
123. 123 Adolfsson, P, Strömgren, A, Mattsson, S, Chaplin, J, Jendle, J, Education and individualized support regarding exercise and diabetes improves glucose control and level of physical activity in type 1 diabetes individuals. J Endocrinol Diabetes Obes, 3, 2015, 1071.
124. 124 Danne, T, Tsioli, C, Kordonouri, O, et al. The PILGRIM study: in silico modeling of a predictive low glucose management system and feasibility in youth with type 1 diabetes during exercise. Diabetes Technol Ther 16 (2014), 338–347.
125. 125 Riddell, MC, Zaharieva, DP, Yavelberg, L, Cinar, A, Jamnik, VK, Exercise and the development of the artificial pancreas: one of the more difficult series of hurdles. J Diabetes Sci Technol 9 (2015), 1217–1226.