Continuous moderate‐intensity exercise with or without intermittent high‐intensity work: effects on acute and late glycaemia in athletes with Type 1 diabetes mellitus

Abstract

Although the decreases in glucose level during continuous moderate-intensity exercise and continuous moderate-intensity + intermittent high-intensity exercise are similar, the latter form of exercise protects against nocturnal hypoglycaemia in athletes with Type 1 diabetes.

Quantifying the Acute Changes in Glucose with Exercise in Type 1 Diabetes: A Systematic Review and Meta-Analysis

“…During the process of peer review for this report, journal reviewers identified one extra study that fulfilled our inclusion criteria: Yardley et al [28]. Table 1 summarizes the main characteristics of the final ten publications [28][29][30][31][32][33][34][35][36][37] incorporated in this systematic review and meta-analysis.…”

“…Most articles (six of ten) presented glucose data as changes from baseline glycemia, either at the onset of the exercise session [29][30][31]33] or at some other reference instant: 90 min before the start of physical activity [35] or 20 min before the bout [36].…”

“…Most studies required that physical exertions were at least 1 week apart, with some using shorter washouts, although never less than 2 days. Several researchers instructed participants to refrain from any physical activity in the 24^-8 h prior to the test [30,31,33] or to maintain their usual lifestyle [36]. Three publications did not clearly comment on preceding physical activity [28,29,35].…”

“…Negative rate-of-change values indicate glycemia decaying more rapidly; or conversely recovering more slowly, in the intermittent high-intensity exercise sessions than for the continuous bout. CI confidence interval, CONT continuous physical activity, REST resting control period, RoC rate of change, ROCE glycemia RoC during exercise, ROCR glycemia RoC at recovery, wrt with respect to CONT based on three studies [30,31,33], and RESIST vs. CONT with one study [28]. For the IHE vs. CONT comparison (see Fig.…”

“…6) resulted in ROCE {IHE vs. CONT} = +2.86 mmol/L h _1 (95 % CI -1.49 to +7.20; I 2 41 %), with three studies involved; hence pointing to a slower decline in glycemia for IHE than for CONT (p -0.15, not significant). The scarcity of available studies involving IHE (four in total [29][30][31]33], with Iscoe and Riddell [31] presenting REST, CONT, and IHE trial arms) may explain this shortcoming to some extent. We also encountered statistical heterogeneity (/ 53 % for ROCE {IHE vs. CONT}) and a substantial methodological diversity among study protocols; in particular, in the definition of the IHE session.…”