Physical exercise in type 1 diabetes: recommendations and care

Luis Paulo Gomes Mascarenhas,Gabriela De Carvalho Kraemer,Kátia Regina Castro De Lacerda,Suzana Nesi-França,Valderi Abreu De Lima,Juliana Pereira Decimo

doi:10.1590/s1980-6574201600040001

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.Keywords: diabetes mellitus, type 1, exercise, physical activity, blood glucose, nutrition therapy

Highlights

Treatment of type 1 diabetes mellitus (T1DM) is comprised of medications, proper nutrition, and regular physical activity[1]
Athletic activities are considered safe for patients with T1DM, provided that the athletes and the multidisciplinary team caring for them pay attention during the exercise to the particularities and requirements of the disease[2]
There are frequent reports of hyperglycemia before, during, and after some types of exercises, which add to the risk of ketoacidosis, and chronic microvascular and macrovascular complications may hinder the career of athletes with T1DM4,5,6

Summary

Mini Review

Luis Paulo Gomes Mascarenhas Universidade Estadual do Centro Oeste, Irati, PR, Brasil. 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. 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.

Introduction

During the activity

After the activity

Recommendations for ingestion of fluids

Findings

Final considerations