1. Techniques for Exercise Preparation and Management in Adults with Type 1 Diabetes
- Author
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Amy Kraus, David Kerr, Eyal Dassau, Benjamen E. Schoenberg, Hallie Ortiz, Satbir K. Singh, Jordan E. Pinsker, and Danielle Gianferante
- Subjects
Adult ,Blood Glucose ,Male ,Insulin pump ,medicine.medical_specialty ,Adolescent ,Endocrinology, Diabetes and Metabolism ,030209 endocrinology & metabolism ,Hypoglycemia ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Quality of life ,Diabetes management ,Diabetes mellitus ,Blood Glucose Self-Monitoring ,Internal Medicine ,medicine ,Humans ,030212 general & internal medicine ,Young adult ,Exercise ,Aged ,Aged, 80 and over ,Type 1 diabetes ,business.industry ,Disease Management ,General Medicine ,Middle Aged ,Prognosis ,medicine.disease ,Self Care ,Diabetes Mellitus, Type 1 ,Quality of Life ,Physical therapy ,Female ,business ,Biomarkers ,Follow-Up Studies - Abstract
People with type 1 diabetes are at risk for early- and late-onset hypoglycemia following exercise. Reducing this risk may be possible with strategic modifications in carbohydrate intake and insulin use. We examined the exercise preparations and management techniques used by individuals with type 1 diabetes before and after physical activity and sought to determine whether use of differing diabetes technologies affects these health-related behaviours.We studied 502 adults from the Type 1 Diabetes Exchange's online patient community, Glu, who had completed an online survey focused on diabetes self-management and exercise.Many respondents reported increasing carbohydrate intake before (79%) and after (66%) exercise as well as decreasing their meal boluses before (53%) and after (46%) exercise. Most reported adhering to a target glucose level before starting exercise (77%). Despite these accommodations, the majority reported low blood glucose (BG) levels after exercise (70%). The majority of users of both insulin pump therapy (CSII) and continuous glucose monitoring (CGM) (Combined) reported reducing basal insulin around exercise (55%), with fewer participants adjusting basal insulin when using other devices (SMBG only = 20%; CGM = 34%; CSII = 42%; p0.001). However, CSII and Combined users reported that exercise makes their BG levels harder to control (p0.05) and makes them feel less able to predict their BG levels while exercising (p0.001); they show agreement that fear of low BG levels keeps them from exercising (p0.01).These findings highlight the need for exercise-management strategies tailored to individuals' overall diabetes management, for despite making exercise-specific adjustments for care, many people with type 1 diabetes still report significant difficulties with BG control when it comes to exercise.
- Published
- 2016
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