Important paper on Type 1 Diabetes and Exercise

New paper published in The Lancet Diabetes & Endocrinology recommends exercise guidelines for type 1 diabetes patients and healthcare providers.

Experts from JDRF, the leading global organization focused on type 1 diabetes (T1D) research, as part of an international team of 21 researchers and clinicians led by York UniversityProfessor Michael Riddell, published first-of-its-kind guidelines to help people with type 1 diabetes exercise safely.

The report, “Exercise management in type 1 diabetes: a consensus statement,” published this week in The Lancet Diabetes & Endocrinology, offers guidelines on glucose targets for safe and effective exercising with T1D, as well as nutritional and insulin dose adjustments to prevent exercise-related fluctuations in blood sugar.

“Exercise has tremendous benefits for people with T1D, but it can be hard to predict how it will affect their blood glucose and how they feel during and following physical activity,” said Aaron Kowalski, Ph.D., JDRF Chief Mission Officer and contributor to the report. “The lack of reliable information on how to exercise safely has created obstacles for people with T1D who want to maintain a healthy lifestyle. These consensus guidelines, as well as JDRF’s new PEAK program, are breaking down those barriers.”

For two years, the team of experts reviewed observational studies and clinical trials on exercise management for people with T1D who exercise regularly. As a result, the JDRF-funded report identifies how different types of exercise can reduce or increase glucose levels, to help inform changes to an exercise routine to ensure safe and effective glycemic management.

“Regular exercise can help individuals with diabetes to achieve their blood lipid, body composition, fitness and blood sugar goals, but for people living with type 1 diabetes, the fear of hypoglycemia, loss of glycemic control, and inadequate knowledge around exercise management are major barriers,” said Michael Riddell, a professor at the Faculty of Health at Toronto’s York U. “This is a big struggle for both type 1 diabetes patients and their healthcare providers. This first ever set of consensus guidelines from leading experts will help them.”

The authors note that a large percentage of people with T1D do not maintain a healthy body mass or achieve the minimum required moderate-to-vigorous aerobic activity (150 minutes per week). Also, a majority of people with type 1 diabetes are now overweight or obese, compared to a few decades ago when most people with T1D were relatively slim and active.

Exercise lowers average blood glucose levels, reduces the amount of insulin needed daily, and reduces the risk of cardiovascular disease, diabetic eye disease and microalbuminuria (urine albumin). The report also suggests that exercise gives people with T1D a better chance of achieving target levels of glycated hemoglobin (HbA1) levels, blood pressure levels and a healthier body mass index when compared to inactive patients.

The Need for Exercise Education in the T1D Community

The guidelines come at a time when JDRF is launching its T1D Performance in Exercise and Knowledge (PEAK) initiative to educate people with T1D, their caregivers and their healthcare professionals on how to pursue physical activity safely. In 2017, the PEAK program will commence its global rollout with workshops hosted in cities across the United States and JDRF affiliate countries. The team responsible for the consensus guidelines featured in The Lancet Diabetes & Endocrinology includes several experts involved in the JDRF PEAK program.

Source: JDRF (www.jdrf.org)