The competitive athlete with type 1 diabetes

• Published in: Diabetologia Vol. 63; no. 8; pp. 1475 - 1490
• Main Authors: Riddell, Michael C., Scott, Sam N., Fournier, Paul A., Colberg, Sheri R., Gallen, Ian W., Moser, Othmar, Stettler, Christoph, Yardley, Jane E., Zaharieva, Dessi P., Adolfsson, Peter, Bracken, Richard M.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-08-2020; Springer Nature B.V
• Subjects: acute-weight-loss; amino-acids; Athlete; Athletes; blood-glucose responses; Carbohydrate; Competition; Continuous glucose monitoring; control; Diabetes; Diabetes mellitus (insulin dependent); Endocrinology & Metabolism; Endocrinology and Diabetes; Endokrinologi och diabetes; Exercise; Exercise and diabetes; exercise-induced; Glucose; Glucose monitoring; glycemic; Glycogen; Human Physiology; hypoglycemia; Insulin; Internal Medicine; Medicine; Medicine & Public Health; Metabolic Diseases; Metabolic response; muscle glycogen utilization; nocturnal; Nutrition; postexercise hyperglycemia; rapid-acting insulin; Review; skeletal-muscle; Sport; Type 1 diabetes; Competition; Continuous glucose monitoring; Sport; Exercise; Nutrition; Type 1 diabetes; Carbohydrate; Glucose; Review; Athlete; Insulin
• ISSN: 0012-186X; 1432-0428
• DOI: 10.1007/s00125-020-05183-8

Regular exercise is important for health, fitness and longevity in people living with type 1 diabetes, and many individuals seek to train and compete while living with the condition. Muscle, liver and glycogen metabolism can be normal in athletes with diabetes with good overall glucose management, and exercise performance can be facilitated by modifications to insulin dose and nutrition. However, maintaining normal glucose levels during training, travel and competition can be a major challenge for athletes living with type 1 diabetes. Some athletes have low-to-moderate levels of carbohydrate intake during training and rest days but tend to benefit, from both a glucose and performance perspective, from high rates of carbohydrate feeding during long-distance events. This review highlights the unique metabolic responses to various types of exercise in athletes living with type 1 diabetes.
Graphical abstract