Aerobic exercise was slightly more effective than interval or resistance exercise, but all types improved short-term control.

Knowing the relative value of different types of exercise in lowering blood glucose could help in advising patients who seek exercise options. In this North American trial, researchers randomised 497 adults (mean age, 37 years) with type 1 diabetes to aerobic, high-intensity interval or resistance exercise sessions at home. Each group completed at least six 30-minute, video-guided exercise sessions, with continuous glucose monitoring, during four weeks. The aerobic and interval groups had specified target heart rates, and the resistance group had a muscle-fatigue target.

During the exercise sessions, mean decreases in glucose levels were 1.00, 0.78 and 0.50mmol/L for the aerobic, interval and resistance groups, respectively. On exercise days (compared with sedentary days), participants spent about 6% more time with glucose levels in the 3.9 to 10.0mmol/L range, regardless of exercise group. However, the percentage of days with hypoglycaemic events (blood glucose level below 3.00mmol/L for at least 15 minutes) was higher on exercise days than on sedentary days (13% vs 10%).

Comment: The take-home message here is that any type of exercise has glucose-lowering effects in patients with type 1 diabetes, with some additional risk for hypoglycaemia. Notably, changes in glycaemia were not simply transient during exercise; they also extended into the rest of an exercise day – suggesting an increase in insulin sensitivity that persisted beyond the exercise session.

Thomas L. Schwenk, MD, Professor Emeritus, Family and Community Medicine, University of Nevada School of Medicine, Reno, USA.

Riddell MC, et al. Examining the acute glycemic effects of different types of structured exercise sessions in type 1 diabetes in a real-world setting: the Type 1 Diabetes and Exercise Initiative (T1DEXI). Diabetes Care 2023; 46: 704-713.

This summary is taken from the following Journal Watch titles: General Medicine, Ambulatory Medicine.