Physical exercise in type 1 diabetes: recommendations and care

ABSTRACT

Abstract - The management of type 1 diabetes mellitus (T1DM) is based on three pillars insulin therapy, nutrition, and regular practice of physical activity. Physical exercises are associated with metabolic demands that depend on the individual's energy stores and level of physical conditioning, and vary according to environmental conditions and intensity, duration, and type of exercise. All these factors, added to eventual distress with competitions, exert influence on glucose metabolism. The athletic career of diabetic individuals is often hindered by a risk of hypoglycemia during and after the exercise, frequent hyperglycemia before, during, and after certain physical activities, occurrence of ketoacidosis, and presence of chronic microvascular and macrovascular complications. Aerobic exercises reduce the levels of blood glucose while anaerobic exercise may promote transient hyperglycemia. Although diabetic individuals may achieve excellence in sport, their physical performance should be maximized by strict blood glucose control, adequate modifications in insulin dose on the day of the exercise, and appropriate nutritional intake. This review discusses the impact of physical exercise on glucose metabolism, as well as nutritional considerations and strategies appropriate to the practice of physical exercises by patients with T1DM.