Practical Aspects and Exercise Safety Benefits of Automated Insulin Delivery Systems in Type 1 Diabetes

Dessi P Zaharieva; Dale Morrison; Barbora Paldus; Rayhan A Lal; Bruce A Buckingham; David N O'Neal

doi:10.2337/dsi22-0018

Practical Aspects and Exercise Safety Benefits of Automated Insulin Delivery Systems in Type 1 Diabetes

Diabetes Spectr. 2023 May;36(2):127-136. doi: 10.2337/dsi22-0018. Epub 2023 May 15.

Authors

Dessi P Zaharieva¹, Dale Morrison², Barbora Paldus^{2

3}, Rayhan A Lal^{1

4

5}, Bruce A Buckingham^{1

4}, David N O'Neal^{2

3}

Affiliations

¹ Division of Endocrinology, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA.
² Department of Medicine, The University of Melbourne, Melbourne, Australia.
³ Department of Endocrinology & Diabetes, St Vincent's Hospital Melbourne, Melbourne, Australia.
⁴ Stanford Diabetes Research Center, Stanford, CA.
⁵ Division of Endocrinology, Department of Medicine, Stanford University School of Medicine, Stanford, CA.

Abstract

Regular exercise is essential to overall cardiovascular health and well-being in people with type 1 diabetes, but exercise can also lead to increased glycemic disturbances. Automated insulin delivery (AID) technology has been shown to modestly improve glycemic time in range (TIR) in adults with type 1 diabetes and significantly improve TIR in youth with type 1 diabetes. Available AID systems still require some user-initiated changes to the settings and, in some cases, significant pre-planning for exercise. Many exercise recommendations for type 1 diabetes were developed initially for people using multiple daily insulin injections or insulin pump therapy. This article highlights recommendations and practical strategies for using AID around exercise in type 1 diabetes.