Type 1 Diabetes

Key Reading

Chimen, M., Kennedy, A., Nirantharakumar, K., Pang, T. T., Andrews, R., & Narendran, P. (2012). What are the health benefits of physical activity in type 1 diabetes mellitus? A literature review. Diabetologia, 55(3), 542-551. https://link.springer.com/article/10.1007/s00125-011-2403-2

Chu, L., Hamilton, J., & Riddell, M. C. (2011). Clinical management of the physically active patient with type 1 diabetes. The Physician and Sportsmedicine, 39(2), 64-77. https://doi.org/10.3810/psm.2011.05.1896

Codella, R., Terruzzi, I., & Luzi, L. (2017). Why should people with type 1 diabetes exercise regularly?. Acta Diabetologica, 1-16. https://link.springer.com/article/10.1007/s00592-017-0978-x

Colberg SR, Sigal RJ, Yardley JE, et al (2016) Physical activity/exercise and diabetes: A position statement of the American Diabetes Association. Diabetes Care 39:2065–2079. doi: 10.2337/dc16-1728

Colberg SR (2017) Key Points from the Updated Guidelines on Exercise and Diabetes. Front Endocrinol 8:33. doi: 10.3389/fendo.2017.00033

Farinha, J. B., Krause, M., Rodrigues-Krause, J., & Reischak-Oliveira, A. (2017). Exercise for type 1 diabetes mellitus management: general considerations and new directions. Medical hypotheses, 104, 147-153. https://doi.org/10.1016/j.mehy.2017.05.033

Galassetti, P., & Riddell, M. C. (2013). Exercise and type 1 diabetes (T1DM). Comprehensive Physiology. http://onlinelibrary.wiley.com/doi/10.1002/cphy.c110040/abstract

Figure from Riddell et al (2017) doi: 10.1016/S2213-8587(17)30014-1Variability in blood glucose responses to different forms of exercise in people with type 1 diabetes "High individual variability exists in the blood glucose responses to diff erent form of exercise, as denoted by the arrows and grey shading. In general, aerobic exercise decreases glycaemia, anaerobic exercise increases glycaemia, and mixed activities are associated with glucose stability. Individual responses are dependent on various additional factors, including the duration and intensity of the activity, initial blood glucose concentrations, individual fi tness, concentrations of insulin, glucagon, and other counter-regulatory hormones in the circulation, and the nutritional status of the individual."

Riddell MC, Gallen IW, Smart CE, et al (2017) Exercise management in type 1 diabetes: a consensus statement. Lancet Diabetes Endocrinol 8587:1–14. doi: 10.1016/S2213-8587(17)30014-1

Pinsker JE, Kraus A, Gianferante D, et al (2016) Techniques for Exercise Preparation and Management in Adults with Type 1 Diabetes. Can J Diabetes 40:503–508. doi: 10.1016/j.jcjd.2016.04.010

Click here to see a resource page for patients on our OneLife T1D exercise referral scheme

Reading List

Ahola AJ, Saraheimo M, Freese R, et al (2016) Fear of hypoglycaemia and self-management in type 1 diabetes. J Clin Transl Endocrinol 4:13–18. doi: 10.1016/j.jcte.2016.02.002

Al Khalifah RA, Suppère C, Haidar A, et al (2016) Association of aerobic fitness level with exercise-induced hypoglycaemia in Type 1 diabetes. Diabet Med 33:1686–1690. doi: 10.1111/dme.13070

Anderbro T, Amsberg S, Adamson U, et al (2010) Fear of hypoglycaemia in adults with Type 1 diabetes. Diabet Med 27:1151–1158. doi: 10.1111/j.1464-5491.2010.03078.x

Atkinson M, Eisenbarth GS, Michels AW (2014) Type 1 diabetes. Lancet 383:69–82. doi: 10.1016/S0140-6736(13)60591-7

Barnard KD, Lloyd CE, Skinner TC (2007) Systematic literature review: Quality of life associated with insulin pump use in type 1 diabetes. Diabet Med 24:607–617. doi: 10.1111/j.1464-5491.2007.02120.x

Bastiaens H, Sunaert P, Wens J, et al (2009) Supporting diabetes self-management in primary care: Pilot-study of a group-based programme focusing on diet and exercise. Prim Care Diabetes 3:103–109. doi: 10.1016/j.pcd.2009.02.001

Bode BW, Kaufman FR, Vint N (2017) An Expert Opinion on Advanced Insulin Pump Use in Youth with Type 1 Diabetes. Diabetes Technol Ther 19:dia.2016.0354. doi: 10.1089/dia.2016.0354

Böhme P, Bertin E, Cosson E, et al (2013) Fear of hypoglycaemia in patients with type 1 diabetes: Do patients and diabetologists feel the same way? Diabetes Metab 39:63–70. doi: 10.1016/j.diabet.2012.10.006

Bohn B, Herbst A, Pfeifer M, et al (2015) 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 38:1536–1543. doi: 10.2337/dc15-0030

Bott U, Mühlhauser I, Overmann H, Berger M (1998) Validation of a diabetes-specific quality-of-life scale for patients with type 1 diabetes. Diabetes Care 21:757–769. doi: 10.2337/diacare.21.5.757

Brazeau A-S, Gingras V, Leroux C, et al (2014) A pilot program for physical exercise promotion in adults with type 1 diabetes: the PEP-1 program. Appl Physiol Nutr Metab 39:465–471. doi: 10.1139/apnm-2013-0287

Brazeau A-S, Mircescu H, Desjardins K, et al (2012) The Barriers to Physical Activity in Type 1 Diabetes (BAPAD-1) scale: Predictive validity and reliability. Diabetes Metab 38:164–170. doi: 10.1016/j.diabet.2011.10.005

Brazeau A-S, Strychar I, Rabasa-Lhoret R, Mircescu H (2008) Barriers to Physical Activity Among Patients With Type 1 Diabetes. Diabetes Care 31:2108–2109. doi: 10.2337/dc08-0720.

Cherrington A, Martin MY, Hayes M, et al (2012) Intervention mapping as a guide for the development of a diabetes peer support intervention in rural Alabama. Prev Chronic Dis 9:E36. doi: 10.5888/pcd9.110053

Chiang JL, Kirkman MS, Laffel LMB, Peters AL (2014) Type 1 Diabetes Through the Life Span: A Position Statement of the American Diabetes Association. Diabetes Care 37:2034–2054. doi: 10.2337/dc14-1140

Chimen M, Kennedy A, Nirantharakumar K, et al (2012) What are the health benefits of physical activity in type 1 diabetes mellitus? A literature review. Diabetologia 55:542–551. doi: 10.1007/s00125-011-2403-2

Chu, L., Hamilton, J., & Riddell, M. C. (2011). Clinical management of the physically active patient with type 1 diabetes. The Physician and Sportsmedicine, 39(2), 64-77. https://doi.org/10.3810/psm.2011.05.1896

Codella R, Terruzzi I, Luzi L (2017) Why should people with type 1 diabetes exercise regularly? Acta Diabetol. doi: 10.1007/s00592-017-0978-x

Colberg SR (2017) Key Points from the Updated Guidelines on Exercise and Diabetes. Front Endocrinol (Lausanne) 8:33. doi: 10.3389/fendo.2017.00033

Colberg SR, Sigal RJ, Yardley JE, et al (2016) Physical activity/exercise and diabetes: A position statement of the American Diabetes Association. Diabetes Care 39:2065–2079. doi: 10.2337/dc16-1728

Dubé M-C, Valois P, Prud’homme D, et al (2006) Physical activity barriers in diabetes: Development and validation of a new scale. Diabetes Res Clin Pract 72:20–27. doi: 10.1016/j.diabres.2005.08.008

Figure from Farinha et al (2017) https://doi.org/10.1016/j.mehy.2017.05.033 : "Exercise onset stimulates glucose uptake and glycogenolysis. High-intensity stimulus promote increased catecholamines releasing, which in turn, inhibit insulin-mediated glucose uptake and stimulates gluconeogenesis. In turn, increased lactate production promotes transient inhibition of insulin-mediated glucose uptake, besides stimulates glucose production by the liver. Together, the aforementioned mechanisms contribute with the mild glycaemia reduction when compared with continuous and moderate-intensity exercise in T1DM patients. Dashed arrows indicate possible long-term adaptations induced by the performance of high-intensity interval and hypertrophy-type exercises. "

Farinha, J. B., Krause, M., Rodrigues-Krause, J., & Reischak-Oliveira, A. (2017). Exercise for type 1 diabetes mellitus management: general considerations and new directions. Medical hypotheses, 104, 147-153. https://doi.org/10.1016/j.mehy.2017.05.033

Franciosi M, Maione A, Pomili B, et al (2010) Correlates of quality of life in adults with type 1 diabetes treated with continuous subcutaneous insulin injection. Nutr Metab Cardiovasc Dis 20:7–14. doi: 10.1016/j.numecd.2009.02.012

Frier B, Heller SR, McCrimmon RJ (eds) (2014) Hypoglycaemia in Clinical Diabetes. Wiley-Blackwell, Chichester, West Sussex Galassetti, P., & Riddell, M. C. (2013). Exercise and type 1 diabetes (T1DM). Comprehensive Physiology.

Häyrinen M, Tarkka IM (2016) Physical activity does not inevitably improve quality of life in young adults with type 1 diabetes. Diabetes Res Clin Pract 121:99–101. doi: 10.1016/j.diabres.2016.09.010

Heinemann L, Fleming GA, Petrie JR, et al (2015) Insulin Pump Risks and Benefits: A Clinical Appraisal of Pump Safety Standards, Adverse Event Reporting, and Research Needs. Diabetes Care 38:dc150168. doi: 10.2337/dc15-0168

Jankovec Z, Krcma M, Gruberova J, et al (2011) Influence of Physical Activity on Metabolic State Within a 3-h Interruption of Continuous Subcutaneous Insulin Infusion in Patients with Type 1 Diabetes. Diabetes Technol Ther 13:1234–1239. doi: 10.1089/dia.2011.0121

Kennedy A, Nirantharakumar K, Chimen M, et al (2013) Does Exercise Improve Glycaemic Control in Type 1 Diabetes? A Systematic Review and Meta-Analysis. PLoS One. doi: 10.1371/journal.pone.0058861

Lascar N, Kennedy A, Hancock B, et al (2014) Attitudes and Barriers to Exercise in Adults with Type 1 Diabetes (T1DM) and How Best to Address Them: A Qualitative Study. PLoS One 9:e108019. doi: 10.1371/journal.pone.0108019

Lascar N, Kennedy A, Jackson N, et al (2013) Exercise to preserve beta cell function in recent-onset type 1 diabetes mellitus (EXTOD)--a study protocol for a pilot randomized controlled trial. Trials 14:180. doi: 10.1186/1745-6215-14-180

Martyn-Nemeth P, Schwarz Farabi S, Mihailescu D, et al (2016) Fear of hypoglycemia in adults with type 1 diabetes: Impact of therapeutic advances and strategies for prevention - A review. J Diabetes Complications 30:167–177. doi: 10.1016/j.jdiacomp.2015.09.003

Matthews L, Kirk A, Mutrie N (2014) Insight from health professionals on physical activity promotion within routine diabetes care. Pract Diabetes 31:111–116e. doi: 10.1002/pdi.1844

McAuley SA, Horsburgh JC, Ward GM, et al (2016) Insulin pump basal adjustment for exercise in type 1 diabetes: a randomised crossover study. Diabetologia 59:1636–1644. doi: 10.1007/s00125-016-3981-9

McCarthy MM, Whittemore R, Gholson G, Grey M (2017) Self-management of physical activity in adults with type 1 diabetes. Appl Nurs Res 35:18–23. doi: 10.1016/j.apnr.2017.02.010

McCarthy MM, Whittemore R, Grey M (2016) Physical Activity in Adults With Type 1 Diabetes. Diabetes Educ 42:108–115. doi: 10.1177/0145721715620021

Morrison G, Weston P (2013) Self-efficacy: A tool for people with diabetes managed by continuous subcutaneous insulin infusion. J Diabetes Nurs 17:32–37.

Ozcan S, Amiel S a, Rogers H, et al (2014) Poorer glycaemic control in type 1 diabetes is associated with reduced self-management and poorer perceived health: a cross-sectional study. Diabetes Res Clin Pract 106:35–41. doi: 10.1016/j.diabres.2014.07.023

Patel NS, Van Name MA, Cengiz E, et al (2016) Mitigating Reductions in Glucose During Exercise on Closed-Loop Insulin Delivery: The Ex-Snacks Study. Diabetes Technol Ther 18:794–799. doi: 10.1089/dia.2016.0311

Pinsker JE, Kraus A, Gianferante D, et al (2016) Techniques for Exercise Preparation and Management in Adults with Type 1 Diabetes. Can J Diabetes 40:503–508. doi: 10.1016/j.jcjd.2016.04.010

Plotnikoff RC, Lippke S, Reinbold-Matthews M, et al (2007) Assessing the validity of a stage measure on physical activity in a population-based sample of individuals with type 1 or type 2 diabetes. Meas Phys Educ Exerc Sci 11:73–91.

Plotnikoff RC, Lippke S, Trinh L, et al (2010) Protection motivation theory and the prediction of physical activity among adults with type 1 or type 2 diabetes in a large population sample. Br J Heal Pschology 15:643–661. doi: 10.1348/135910709X478826

Riddell MC, Gallen IW, Smart CE, et al (2017) Exercise management in type 1 diabetes: a consensus statement. Lancet Diabetes Endocrinol 8587:1–14. doi: 10.1016/S2213-8587(17)30014-1

Ryan C (2011) Fear of hypoglycemia: Commentary. Diabet Hypoglycemia 4:17–18. doi: 10.1111/1753-0407.12491

Speight J, Holmes-Truscott E, Harvey DM, et al (2016) Structured type 1 diabetes education delivered in routine care in Australia reduces diabetes-related emergencies and severe diabetes-related distress: The OzDAFNE program. Diabetes Res Clin Pract 112:65–72. doi: 10.1016/j.diabres.2015.11.002

Steineck I, Cederholm J, Eliasson B, et al (2015) Insulin pump therapy, multiple daily injections, and cardiovascular mortality in 18 168 people with type 1 diabetes: observational study. Britiish Med J 350:h3234–h3234. doi: 10.1136/bmj.h3234

Thorpe CT, Fahey LE, Johnson H, et al (2012) Facilitating Healthy Coping in Patients With Diabetes: A Systematic Review. Diabetes Educ. doi: 10.1177/0145721712464400

Tikkanen-Dolenc H, Wadén J, Forsblom C, et al (2016) Frequent and intensive physical activity reduces risk of cardiovascular events in type 1 diabetes. Diabetologia 1–7. doi: 10.1007/s00125-016-4189-8

Withall J, Jago R, Fox KR (2011) Why some do but most don’t. Barriers and enablers to engaging low-income groups in physical activity programmes: a mixed methods study. BMC Public Health 11:507. doi: 10.1186/1471-2458-11-507

Wu, N., Bredin, S. S., Guan, Y., Dickinson, K., Kim, D. D., Chua, Z., ... & Warburton, D. E. (2019). Cardiovascular Health Benefits of Exercise Training in Persons Living with Type 1 Diabetes: A Systematic Review and Meta-Analysis. Journal of Clinical Medicine, 8(2), 253. https://doi.org/10.3390/jcm8020253

Yardley JE, Hay J, Abou-Setta AM, et al (2014) A systematic review and meta-analysis of exercise interventions in adults with type 1 diabetes. Diabetes Res Clin Pract 106:393–400. doi: 10.1016/j.diabres.2014.09.038

Yardley JE, Iscoe KE, Sigal RJ, et al (2013) 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 15:84–8. doi: 10.1089/dia.2012.0168

Yardley JE, Sigal RJ, Perkins BA, et al (2013) Resistance exercise in type 1 diabetes. Can J Diabetes 37:420–426. doi: 10.1016/j.jcjd.2013.07.020

Yardley JE, Zaharieva DP, Jarvis C, Riddell MC (2015) The “Ups” and “Downs” of a Bike Race in People with Type 1 Diabetes: Dramatic Differences in Strategies and Blood Glucose Responses in the Paris-to-Ancaster Spring Classic. Can J Diabetes 39:105–110. doi: 10.1016/j.jcjd.2014.09.003

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