Effects of Postprandial Exercise on Glycaemia and Metabolism in People With Type 1 Diabetes

Change in blood glucose during exercise

A cornerstone in the management and treatment of people living with type 1 diabetes (T1D) is
 to engage in regular physical exercise for a variety of health and fitness reasons. Despite
 these well-established benefits, many people with T1D experience their challenging glycaemic
 condition as a high barrier to exercise. The challenge of managing glycaemia around exercise
 together with fear of hypoglycaemia (FOH) remain major barriers to exercise in T1D patients,
 meaning that many are discouraged from exercise. If people with T1D wish to engage in
 exercise in a safe manner, a certain level of pre-planning before exercise is required in
 terms of insulin dosing and target glucose concentration.
 
 Numerous research projects have been performed in the morning where participants exercise in
 the fasted state, for logistical reasons, because of easier insulin management in fasting
 conditions and a lower risk of hypoglycaemia during or after the exercise bout. However, in
 reality, advanced planning of exercise is not always possible, and many patients may also
 wish to exercise after their meal.
 
 Hence, it is important to take into account the impact of prandial state on blood glucose
 responses to exercise in patients with T1D. While evidence on the importance of timing of
 exercise and on the benefits of postprandial exercise for improving glucose control is
 available in patients with type 2 diabetes, less studies have been conducted in T1D despite
 this being of high clinical importance.
 
 Therefore, more insight is needed into the glycaemic and metabolic effects of different
 postprandial exercise modalities aiming to reduce the risk of hypoglycaemia and improve
 glucose control, both during and after exercise. Postprandial exercise can be a useful
 strategy to improve glycaemic control but research in T1DM is very scarce, with only few
 studies that have been conducted and optimal exercise regimens remaining unknown.
 
 Summarizing, prandial state is an important factor to take into account in exercise in people
 with T1D, with glycaemic responses that substantially vary between fasted or postprandial
 exercise. Performing exercise in the postprandial period is of high clinical relevance
 however there is a scarcity of research in this area. Therefore, more studies that examine
 the glycaemic and metabolic effects of different modalities of postprandial exercise in
 people with T1D are needed. All of this aiming to simplify exercise-associated
 countermeasures and improve (postprandial) glucose control, and thereby reduce barriers to PA
 in this population.