Abstract

Background: The acute impact of different types of physical activity on glycemic control in type 1 diabetes has not been well quantified. Objectives: Our objective was to estimate the rate of change (RoC) in glucose concentration induced acutely during the performance of structured exercise and at recovery in subjects with type 1 diabetes. Methods: We searched for original articles in the PubMed, MEDLINE, Scopus, and Cochrane databases. Search terms included type 1 diabetes, blood glucose, physical activity, and exercise. Eligible studies (randomized controlled trials and non-randomized experiments) encompassed controlled physical activity sessions (continuous moderate [CONT], intermittent high intensity [IHE], resistance [RESIST], and/or a resting reference [REST]) and reported excursions in glucose concentration during exercise and after its cessation. Data were extracted by graph digitization to compute two RoC measures from population profiles: RoCE during exercise and RoCR in recovery. Results: Ten eligible studies were found from 540 publications. Meta-analyses of exercise modalities versus rest yielded the following: RoCE −4.43 mmol/L h−1 (p < 0.00001, 95 % confidence interval [CI] −6.06 to −2.79) and RoCR +0.70 mmol/L h−1 (p = 0.46, 95 % CI −1.14 to +2.54) for CONT vs. REST; RoCE −5.25 mmol/L·h−1 (p < 0.00001, 95 % CI −7.02 to −3.48) and RoCR +0.72 mmol/L h−1 (p = 0.71, 95 % CI −3.10 to +4.54) for IHE vs. REST; RoCE −2.61 mmol/L h−1 (p = 0.30, 95 % CI −7.55 to +2.34) and RoCR −0.02 mmol/L h−1 (p = 1.00, 95 % CI −7.58 to +7.53) for RESIST vs. REST. Conclusions: Novel RoC magnitudes RoCE, RoCR reflected rapid decays of glycemia during CONT exercise and gradual recoveries immediately afterwards. RESIST showed more constrained decays, whereas discrepancies were found for IHE. Verf.-Referat