| Keywords [eng] |
Type 1 diabetes mellitus, physical activity, glucose, hypoglycemia, hyperglycemia, insulin, nutrition, technology, challenges |
| Abstract [eng] |
Type 1 diabetes mellitus (T1DM) is a growing global health concern, particularly among younger populations, due to its autoimmune destruction of pancreatic ß-cells, leading to insulin deficiency and serious complications if not properly managed. This review explores how regular physical exercise can positively impact glucose control in T1DM patients, despite the challenges they face, and aims to identify strategies to optimize exercise benefits through tailored insulin management, diet, and modern technology. The literature review followed a systematic search strategy using PubMed, focusing on studies published between 2015 and 2025 that examined the relationship between T1DM, exercise, glucose control, and technology. After applying specific inclusion and exclusion criteria, and screening of 372 initial records, 92 relevant sources were selected for the final review. Exercise in individuals with T1DM showed to improve short-term glycemic control by increasing time in target glucose range, while evidence on its long-term effect on HbA1c remains mixed. Different training modalities, particularly high-intensity interval training (HIIT) and continuous exercise, have been shown to impact glucose balance in individuals with type 1 diabetes, with HIIT offering more stable glucose levels and reduced hypoglycemia risk, while continuous exercise tends to lower glucose more significantly during and after activity. Despite the clear benefits of physical activity, many adolescents with type 1 diabetes remain inactive due to psychological barriers—particularly fear of hypoglycemia—as well as logistical, physiological, and technological challenges, all of which contribute to poorer glycemic control and reduced overall well-being. To manage exercise-induced glycemic fluctuations in type 1 diabetes, it is crucial to adjust carbohydrate intake based on pre- and post-exercise blood glucose levels, consume carbohydrate-rich foods with a high glycemic index for immediate glycogen replenishment, reduce insulin doses before and after prolonged exercise, monitor glucose frequently, and consume a balanced pre-bedtime snack to prevent nocturnal hypoglycemia, while considering insulin sensitivity, exercise type, and the timing of meals. In recent years, there has been a significant advancement in the field of technology. These advancements have been particularly impactful in the realm of diabetes treatment. Continuous glucose monitoring systems (CGMs), artificial intelligence systems, insulin pumps and supportive applications have been shown to enhance glycemic control, particularly during physical activity. |
