Are Regular Aerobic Exercisers With Type 1 Diabetes Following Current Physical Activity Self-Management Guidelines? Insights From an Online Survey
This study surveyed 102 adults with type 1 diabetes who were a part of online communities for regular exercisers with type 1 diabetes. These individuals, who met or exceeded aerobic exercise guidelines, were evaluated via self-report for their adherence to recommended glucose management strategies before, during, and after physical activity. Although most reported using diabetes-related technologies, 86% of respondents reported having frequent activity-related hypoglycemia. Eighty percent reported using trial-and-error strategies, and only 32% identified their health care professionals as a key source of exercise self-management education. Few followed consensus-based guidelines such as reducing insulin doses before exercise and refraining from exercising within 24 hours after a severe hypoglycemic event. [box] Key Points · Within this active cohort, there was a high prevalence of hypoglycemia, with 49% of participants indicating no hypoglycemia symptoms unless blood glucose was <60 mg/dL (<3.3 mmol/L). Eighty-six percent of respondents experienced exercise-induced hypoglycemia, with 18% having severe hypoglycemic events during exercise and 41% having overnight hypoglycemia. · Before exercise, only 27% of pump users reported adjusting basal insulin in the 60–90 minutes before exercise, and 51% reduced their pre-exercise meal bolus. Forty-two percent engaged their pump’s exercise mode during exercise. · Ten percent of participants experienced diabetic ketoacidosis after exercise, and only 27% restricted exercise in the 24 hours after having a severe hypoglycemic event, highlighting a potential lack of understanding of exercise guidelines. · Only 32% of respondents identified their medical team as a key source of information, whereas up to 80% reported relying on trial and error, social media groups, Google searches, and YouTube videos, underscoring the importance of developing online education resources for this population.