Carbohydrate Intake in the Context of Exercise in People with Type 1 Diabetes

Scott, Sam N.; Kempf, Patrick; Bally, Lia; Stettler, Christoph

doi:10.3390/nu11123017

Cited by 25 publications

(28 citation statements)

References 167 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although trials are undergoing, to date low-and very low-carbohydrate diets have not been extensively studied in the management of T1D [13], with available studies examining glycemic outcomes from such diets being largely cross-sectional and lacking validated dietary data or control subjects [32,98]. Many of the participants in such studies can be described as highly motivated individuals who follow intensive insulin management practices, including frequent blood glucose monitoring and additional insulin corrections to meet tight glycemic targets.…”

Section: Discussionmentioning

confidence: 99%

“…Many of the participants in such studies can be described as highly motivated individuals who follow intensive insulin management practices, including frequent blood glucose monitoring and additional insulin corrections to meet tight glycemic targets. While athletes may still perform adequately when following such restricted diets [32,99,100], some potential negative health consequences of ketogenic and other low-carbohydrate diets have been noted [101,102], and longer term studies are needed to determine how feasible these dietary patterns are for most individuals with T1D [103]. Thus, much work remains to be done to fully determine the extent of the impact of dietary carbohydrate restriction on glycemic outcomes and optimal intake levels, particularly in physically active individuals with T1D.…”

Section: Discussionmentioning

confidence: 99%

“…Whether individuals are participating in sports and activities recreationally or aiming for competitive levels of athletic achievement, their performance can be positively or negatively impacted by a number of nutritional factors, such as intake and timing of macronutrients, availability of micronutrients, hydration status and electrolyte balance, and exercise training practices [12][13][14]. In particular, carbohydrate consumption to fuel the exercise bout and/or for hypoglycemia prevention is an important cornerstone to maintain performance and avoid hypoglycemia [31,32].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Physical Activity, Dietary Patterns, and Glycemic Management in Active Individuals with Type 1 Diabetes: An Online Survey

Colberg

Kannane

Diawara

2021

IJERPH

View full text Add to dashboard Cite

Individuals with type 1 diabetes (T1D) are able to balance their blood glucose levels while engaging in a wide variety of physical activities and sports. However, insulin use forces them to contend with many daily training and performance challenges involved with fine-tuning medication dosing, physical activity levels, and dietary patterns to optimize their participation and performance. The aim of this study was to ascertain which variables related to the diabetes management of physically active individuals with T1D have the greatest impact on overall blood glucose levels (reported as A1C) in a real-world setting. A total of 220 individuals with T1D completed an online survey to self-report information about their glycemic management, physical activity patterns, carbohydrate and dietary intake, use of diabetes technologies, and other variables that impact diabetes management and health. In analyzing many variables affecting glycemic management, the primary significant finding was that A1C values in lower, recommended ranges (<7%) were significantly predicted by a very-low carbohydrate intake dietary pattern, whereas the use of continuous glucose monitoring (CGM) devices had the greatest predictive ability when A1C was above recommended (≥7%). Various aspects of physical activity participation (including type, weekly time, frequency, and intensity) were not significantly associated with A1C for participants in this survey. In conclusion, when individuals with T1D are already physically active, dietary changes and more frequent monitoring of glucose may be most capable of further enhancing glycemic management.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Physical Activity, Dietary Patterns, and Glycemic Management in Active Individuals with Type 1 Diabetes: An Online Survey

Colberg

Kannane

Diawara

2021

IJERPH

View full text Add to dashboard Cite

show abstract

“…First, the participants were not restricted to perform exercise at a specific time during the day, which means that circadian factors could have affected glucose response to exercise. 26 Second, the study may have been underpowered in order to detect the actual difference of 1% in time below range. We based our power calculation on an expected difference of 2% in time below 3.9 mmol/L.…”

Section: Discussionmentioning

confidence: 99%

Time spent in hypoglycemia is comparable when the same amount of exercise is performed 5 or 2 days weekly: a randomized crossover study in people with type 1 diabetes

Steineck

Ranjan

Schmidt

et al. 2021

BMJ Open Diab Res Care

View full text Add to dashboard Cite

IntroductionPeople with type 1 diabetes are recommended to exercise regularly. However, limited evidence exists on how frequency and duration of exercise affect the risk of hypoglycemia. The study aimed to compare the percentage of time spent in hypoglycemia between two 5-day periods with different frequency and duration of physical activity.Research design and methodsIn this outpatient randomized crossover study, 26 participants aged 18–65 years with type 1 diabetes for ≥2 years and insulin pump use for ≥1 year were included. After a 7-day observation period, participants completed two 5-day intervention periods separated by a washout period of at least 14 days. One period included five exercise sessions on 5 consecutive days (5S), each consisting of 4 min of resistance training and 30 min of aerobic exercise. Another period included two exercise sessions on 2 days with at least 2 days in between (2S), each consisting of 10 min of resistance training and 75 min of aerobic exercise. During each period, participants performed in total 150 min of aerobic exercise and 20 min of resistance training and wore continuous glucose monitors (Dexcom G6) and accelerometers (ActiGraph wGT3X-BT).ResultsTwenty insulin pump-treated adults (10 women) with type 1 diabetes completed the study. The baseline median (range) age was 48 (24–64) years, glycated hemoglobin 55 (44–66) mmol/mol, diabetes duration 24 (8–57) years, and body mass index 28.4 (22.3–35.8) kg/m2. No differences were observed between 5S and 2S in the percentage (mean±SD) of time spent below 3.9 mmol/L (3.5%±2.8% vs 4.5%±4.2%, p=0.28), time spent in 3.9–10.0 mmol/L (65.3%±15.0% vs 68.5%±13.6%, p=0.31), time spent above 10.0 mmol/L (31.2%±16.4% vs 27.3%±14.5%, p=0.15), mean glucose (8.7±1.3 mmol/L vs 8.5±1.2 mmol/L, p=0.33) and glycemic variability (35.8%±5.3% vs 35.8%±6.6%, p=0.97).ConclusionsTime spent in hypoglycemia was comparable between the two 5-day periods with different duration and frequency of physical activity.Trial registration numberNCT04089462.

show abstract

“…Within the T1D and exercise literature, the majority of published work has only included young healthy males, and those that have included females tend not to recognise the potential sexrelated impact on their outcomes. As was highlighted previously, 5,60,61 , this is an important issue, as there are likely to be important sex-related differences in metabolic and neuroendocrine responses during and after exercise that will influence glycaemia, carbohydrate requirements, and glycogen resynthesis. Female athletes with T1D may experience important changes in glycaemia that are linked to the menstrual cycle phase.…”

Section: Influence Of Sex Hormones and Menstrual Cycle Phase On Fuel Metabolism And Glycogen Resynthesismentioning

confidence: 94%

Post-exercise recovery for the endurance athlete with type 1 diabetes: a consensus statement

Scott

Fontana

Cocks

et al. 2021

The Lancet Diabetes & Endocrinology

Self Cite

View full text Add to dashboard Cite

In recent years, there has been substantial progress in our knowledge of exercise and type 1 diabetes (T1D), with the development of guidelines for optimal glucose management. In addition, an increasing number of people living with T1D are pushing their physical limits in order to compete at the highest level of sport. However, the post-exercise recovery routine, particularly with a focus on sporting performance, has received little attention within the scientific literature, with most of the focus being placed on insulin or nutritional adaptations to manage glycaemia before and during the exercise bout. The post-exercise recovery period presents an opportunity for maximising training adaption and recovery, and the clinical management of glycaemia through the remainder of the day and overnight. The lack of clear guidance for the post-exercise period means that people with T1D must either develop their own recovery strategies based on individual trial and error or follow guidelines that have been developed for people without diabetes. This review provides an up-to-date consensus on postexercise recovery and glucose management for individuals living with T1D. We aim to: 1) outline the principles and time course of post-exercise recovery, highlighting the implications and challenges for the endurance athlete living with T1D; 2) provide an overview of potential post-exercise recovery strategies that could be used by athletes with T1D to optimise recovery and adaptation, alongside improved glycaemic monitoring and management; 3) highlight the potential for technology to ease the burden of managing glycaemia in the post-exercise recovery period. Search Strategy and Selection CriteriaReferences for this review were identified through searches of PubMed and other relevant biomedical databases for articles containing the terms "type 1 diabetes" or "insulin-dependent diabetes" and "exercise", "post-exercise", or "physical activity", published up until 23 rd December 2020 and restricted to English language publications. Additional searches were done with the following terms for various subtopics within this review: "

show abstract

Carbohydrate Intake in the Context of Exercise in People with Type 1 Diabetes

Cited by 25 publications

References 167 publications

Physical Activity, Dietary Patterns, and Glycemic Management in Active Individuals with Type 1 Diabetes: An Online Survey

Physical Activity, Dietary Patterns, and Glycemic Management in Active Individuals with Type 1 Diabetes: An Online Survey

Time spent in hypoglycemia is comparable when the same amount of exercise is performed 5 or 2 days weekly: a randomized crossover study in people with type 1 diabetes

Post-exercise recovery for the endurance athlete with type 1 diabetes: a consensus statement

Contact Info

Product

Resources

About