What Is Type 1 Diabetes?

Type 1 diabetes is an immune condition where the body cannot make insulin. This is a serious health problem that leads to a life-threatening emergency if not treated. It can also lead to life-changing and long-term complications.

What Is Insulin?

Insulin is a hormone produced by cells in the pancreas. The pancreas is an organ in the digestive system.

What Does Insulin Do?

Insulin helps the body to use and store energy (glucose and fat that we eat and drink).

What Happens When the Body Doesn’t Make Insulin?

Without insulin, glucose stays in the blood rather than being “absorbed” into the body. This results in “high blood sugar”. The body cannot use it for energy and then cannot function or run normally. This is a life-threatening situation, often resulting in a diabetic coma.

What Is Insulin Medicine?

People with type 1 diabetes need to take insulin medicine. The insulin medicine keeps their body working normally. Without it they can get sick very quickly.

What Is Automatic Insulin Delivery?

Throughout the day insulin needs to be injected into the body and a person’s blood sugar levels must also measured. This is to make sure that they are taking the right amount of insulin medicine.

Injecting insulin and testing blood sugar levels is difficult and uncomfortable. For many years, the only option was to give insulin injections and take finger-prick blood tests. But recently, gadgets have been developed to make this easier. These are small, smart devices that are permanently attached to the body through the skin. They are sometimes known as an artificial pancreas. They test blood sugar levels and automatically pump insulin into the body. These devices are known as automatic insulin delivery systems, or AID systems.

How Does Physical Exercise and Eating and Drinking Affect Diabetic Health?

The amount of insulin medicine needed depends a lot on how much exercise, food and drink a person has. Different types of physical exercise change the amount of energy the body needs, and how quickly it uses up any energy from food or drink. Similarly, different types of food and drink change the amount of energy that the body must process and how quickly the blood sugar levels are affected. People with type 1 diabetes must continually balance exercise with eating, drinking, blood sugar levels, and insulin levels.

Why Is a Consensus Needed about Exercise and AID Systems?

1. Self-management of this balance between eating, drinking, and exercise is often challenging for people with type 1 diabetes.
2. Physical exercise is very important for long-term health in people with diabetes. Therefore, it is a priority to support people in exercising regularly whilst keeping their diabetes under control.
3. Different advice is needed depending on the type of exercise, and whether it is planned or unplanned.
4. Until this article, there was no up-to-date information and research on using AID systems with physical exercise.

How Did They Agree on the Advice?

International clinicians and researchers were chosen to work together. Internationally recognised methods for finding research were carried out (a literature review). Previous position statements were reviewed. Also, drafts were reviewed by patients (or caregivers of child patients) and other experts not involved in the original writing. This meant that the advice was agreed on by all relevant experts, and that the advice is relevant, clear, and understandable for patients and caregivers.

What Was the Advice?

The advice and recommendations are quite detailed, with information for many specific scenarios. So, it is not possible to list the recommendations in this summary. The advice covers things such as how and whether to raise or lower the settings on the AID system, how often to check the measurements, and different types of planned and unplanned exercise. This also includes exercise in difficult environments such as hot or cold weather, water-based exercise, and high-altitude exercise. The article gives individual information for specific devices.

If you, or someone you know, has type 1 diabetes and wants to find out more about exercise and using an AID system, then it is best to discuss this article with a specialist diabetes healthcare professional.

Note: Some of the authors of this paper make a declaration about grants, research support, consulting fees, lecture fees, honoraria, etc. received from pharmaceutical companies. It is normal for authors to declare this in case it might be perceived as a conflict of interest. For more detail, see the Funding Statement and the Authors’ Relationships and Activities Statement at the end of the paper.